Provider Demographics
NPI:1073025979
Name:GRAHAM, BRIANNA MARIE
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:BRIANNA
Other - Middle Name:MARIE
Other - Last Name:BRIEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1019 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3332
Mailing Address - Country:US
Mailing Address - Phone:607-733-7661
Mailing Address - Fax:607-733-7675
Practice Address - Street 1:1019 E WATER ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3332
Practice Address - Country:US
Practice Address - Phone:607-733-7661
Practice Address - Fax:607-733-7675
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor