Provider Demographics
NPI:1326286451
Name:GRAHAM, JOYCE LOUISE (MS)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:LOUISE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1418
Mailing Address - Country:US
Mailing Address - Phone:303-888-0224
Mailing Address - Fax:
Practice Address - Street 1:2622 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3024
Practice Address - Country:US
Practice Address - Phone:303-888-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO782101YP2500X
COLPC.0000782101YP2500X
IDLCPC.8732101YP2500X
WYLPC.2053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional