Healthcare Provider Details

I. General information

NPI: 1467357558
Provider Name (Legal Business Name): GRAHAM CLINICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 LACEY RD
FORKED RIVER NJ
08731-1304
US

IV. Provider business mailing address

747 LACEY RD
FORKED RIVER NJ
08731-1304
US

V. Phone/Fax

Practice location:
  • Phone: 848-888-3204
  • Fax:
Mailing address:
  • Phone: 848-888-3204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: CARA GRAHAM
Title or Position: OWNER
Credential: BCBA
Phone: 908-208-7614