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General NPI Number Information
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NPI Number | 1568815124
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Entity Type | Organization
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Legal Business Name | CYNTHIA GRAHAM COUNSELING
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 1400 POLY DR SUITE 4E
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City | BILLINGS
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State | MT
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Zip | 59102-1798
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Country | US
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Telephone | 406-252-4978
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 GRAND AVE SUITE 301
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City | BILLINGS
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State | MT
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Zip | 59102-4282
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Country | US
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Telephone | 406-702-2309
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Fax |
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Authorized Official
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Title or Position | COUNSLOR
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Name | CYNTHIA ELAINE GRAHAM I
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Credential | LCPC
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Telephone | 406-702-2309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCPC1530
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License Number State | MT
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