Individual
KAITLYN CHACE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 HUGH WALLIS RD S STE B2, LAFAYETTE, LA 70508-2528
(337) 205-4444
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
010912908
LA
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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