Provider Demographics
NPI:1821101049
Name:GRAHAM, GINGER DORETTA (MA, NCC)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:DORETTA
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 ORLEANS PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3401
Mailing Address - Country:US
Mailing Address - Phone:202-538-2423
Mailing Address - Fax:
Practice Address - Street 1:10506 THRIFT RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3734
Practice Address - Country:US
Practice Address - Phone:202-538-2423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator