Eda Graham
Counselor, School in Ravena, NY. Individual provider (NPI-1).
NPI number1558087296
StatusActive
Last updated in NPPESOct 14, 2022
Details
- NPI
- 1558087296
- Entity type
- Individual (NPI-1)
- Name
- Eda Graham
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 14, 2022
- Certification date
- Oct 7, 2022
- Last updated
- Oct 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YS0200X | Counselor, School | 117708 | NY | Yes |
Practice location
2025 Route 9wRavena, NY 12143
Phone 518-935-8258
Mailing address
21 Park Ln S Apt 2Menands, NY 12204-1940
Phone 518-935-8258
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