Individual
THERESA BOYKIN GRANEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3005 BLADENSBURG RD NE, WASHINGTON, DC 20018-2265
(202) 640-1809
Mailing address
4805 KING CT, BOWIE, MD 20720-3539
(301) 806-0830
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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