Provider Information for 1538337159
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Mrs. SAMANTHA L GRAHAM-DOUGLAS LPC
Sex: Female
NPI: 1538337159
Last Updated: 2023-04-24
Certification Date: 2023-04-24
Certification Date: 2023-04-24
Details
Name | Value | ||||||||||||
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NPI | 1538337159 | ||||||||||||
Enumeration Date | 2008-02-17 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 124 WILD TURKEY LN TROY, MO 63379-4339 United States Phone: 636-358-6021 | Fax:636-338-4203 | ||||||||||||
Primary Practice Address | 681 S LINCOLN DR STE 3 TROY, MO 63379-2835 United States Phone: 636-528-4333 | Fax:636-338-4203 | ||||||||||||
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