Individual
MISS ANASTASIA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
827 W PRAIRIE AVE, HAYDEN, ID 83835-8459
(208) 660-9378
(208) 758-8527
Mailing address
827 W PRAIRIE AVE, HAYDEN, ID 83835-8459
(208) 660-9378
(208) 758-8527
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-5411
ID
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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