Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 06048213 | GA |
NPI | 1215140132 |
---|---|
Provider Name | Dr. Brenda B. Graham |
First Address | Savannah, GA 31406-3218 |
Second Address | Savannah, GA 31406-2569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 13/02/2017 |