Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | NY |
NPI | 1003121195 |
---|---|
Provider Name | Alistair Graham |
First Address | New York, NY 10003 |
Second Address | New York, NY 10003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2010 |
Last Update Date | 29/01/2016 |