Individual
LECENDA V GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3808 VALLEY TREE DR, TAMPA, FL 33610-9353
(813) 359-7008
Mailing address
2813 ASTON AVE, PLANT CITY, FL 33566-9571
(813) 359-7008
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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