Individual
LATRISHA TAMARA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 ALLEN RD, PORTSMOUTH, VA 23702-2202
(757) 975-3698
Mailing address
350 FAIRWAY DR STE 101, DEERFIELD BEACH, FL 33441-1834
(877) 418-2978
(866) 500-2186
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
11/28/2023
Last updated
01/10/2024
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