Individual
MR. BLAKE ALAN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
3551 TIFTONIA DR, CHATTANOOGA, TN 37419-1326
(423) 718-2178
Mailing address
3551 TIFTONIA DR, CHATTANOOGA, TN 37419-1326
(423) 718-2178
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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