Provider Information for 1487311692
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DIANE MICHELLE GRAHAM
Other Names:Former Name:DIANE MICHELLE SPENCER LICSW, LCSWSex: Female
NPI: 1487311692
Last Updated: 2021-11-22
Certification Date: 2021-11-22
Certification Date: 2021-11-22
Details
| Name | Value | ||||||||
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| NPI | 1487311692 | ||||||||
| Enumeration Date | 2021-11-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 18415 E SHARP AVE SPOKANE VALLEY, WA 99016-8524 United States Phone: 509-655-4425 | Fax: | ||||||||
| Primary Practice Address | 18415 E SHARP AVE SPOKANE VALLEY, WA 99016-8524 United States Phone: 509-655-4425 | Fax: | ||||||||
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