Provider Demographics
NPI:1841067246
Name:GRAHAM, MAUREEN NELAINE
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:NELAINE
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 1:213 BURMONT RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-2115
Mailing Address - Country:US
Mailing Address - Phone:717-333-7750
Mailing Address - Fax:
Practice Address - Street 1:213 BURMONT RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-2115
Practice Address - Country:US
Practice Address - Phone:717-333-7750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health