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General NPI Number Information
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NPI Number | 1023060704
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Entity Type | Individual
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Provider Name | SARA ROBERTSON GRAHAM LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 12/29/2009
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Provider Practice Location Address
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Address Line | 15444 US HIGHWAY 17 N
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City | HAMPSTEAD
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State | NC
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Zip | 28443-3548
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Country | US
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Telephone | 910-470-1559
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 907
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City | HAMPSTEAD
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State | NC
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Zip | 28443-0907
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Country | US
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Telephone | 910-470-1559
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C004075
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License Number State | NC
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