Provider Demographics
NPI:1831089333
Name:GRAHAM, ALICE MARIE
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:MARIE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6749
Mailing Address - Country:US
Mailing Address - Phone:240-274-0522
Mailing Address - Fax:
Practice Address - Street 1:6212 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6749
Practice Address - Country:US
Practice Address - Phone:240-274-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32514104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker