Most Relevant Information
Provider Data
| NPI Number: | 1003366584 |
| Provider Name: | MAISHA GRAHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/10/2016 |
| Last Updated: | 05/01/2017 |
Provider Practice Location
871 KNICKERBOCKER AVE APT 2F
BROOKLYN
NY
112071376
Practice Location Phone/Fax
| Phone: | 9124017427 |
| Fax: |
Provider Mailing Location
871 KNICKERBOCKER AVE APT 2F
BROOKLYN
NY
112071376
Provider Mailing Phone/Fax
| Phone: | 9124017427 |
| Fax: |