Provider Demographics
NPI:1386947505
Name:GRAHAM, LESLEY (PSYD)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 DONMOOR CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2500
Mailing Address - Country:US
Mailing Address - Phone:919-662-9517
Mailing Address - Fax:919-662-9515
Practice Address - Street 1:146 DONMOOR CT
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-2500
Practice Address - Country:US
Practice Address - Phone:919-662-9517
Practice Address - Fax:919-662-9515
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling