Provider Demographics
NPI:1346595790
Name:GRAHAM, JANELLE MARIE (BACHELORS DEGREE)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:MARIE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:BACHELORS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CLARK AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1408
Mailing Address - Country:US
Mailing Address - Phone:413-582-0472
Mailing Address - Fax:413-582-1807
Practice Address - Street 1:17 NEW SOUTH ST STE 116
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4075
Practice Address - Country:US
Practice Address - Phone:413-582-0472
Practice Address - Fax:413-582-1807
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor