Individual
MR. RICHARD DWIGHT GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3270 LYNN RIDGE DR APT 2E, RALEIGH, NC 27613-8921
(828) 507-3424
Mailing address
3270 LYNN RIDGE DR APT 2E, RALEIGH, NC 27613-8921
(828) 507-3424
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5993
NC
Other
Enumeration date
11/02/2009
Last updated
03/11/2014
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