Provider Demographics
NPI:1346697554
Name:GRAHAM, SARA EMILY
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:EMILY
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LABOR IN VAIN RD
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2349
Mailing Address - Country:US
Mailing Address - Phone:978-500-1404
Mailing Address - Fax:
Practice Address - Street 1:41 MASON ST
Practice Address - Street 2:1
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2260
Practice Address - Country:US
Practice Address - Phone:978-745-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health