Individual
MRS. TERESA TERRELL GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPA, RD, LD, CLC
Contact information
Practice address
1306 S SLAPPEY BLVD, SUITE-G, BOX 7, ALBANY, GA 31701-2699
(229) 430-4111
(229) 430-3866
Mailing address
PO BOX 3487, ALBANY, GA 31706-3487
(229) 347-4446
(229) 430-3866
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002836
GA
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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