Most Relevant Information
Provider Data
| NPI Number: | 1003682378 |
| Provider Name: | LATRISHA TAMARA GRAHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/28/2023 |
| Last Updated: | 01/10/2024 |
Provider Practice Location
100 ALLEN RD
PORTSMOUTH
VA
237022202
Practice Location Phone/Fax
| Phone: | 7579753698 |
| Fax: |
Provider Mailing Location
350 FAIRWAY DR STE 101
DEERFIELD BEACH
FL
334411834
Provider Mailing Phone/Fax
| Phone: | 8774182978 |
| Fax: | 8665002186 |