Individual
ANNELISE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1558 E BOULEVARD STE A, KOKOMO, IN 46902-2587
(765) 252-0530
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-325723
IN
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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