Individual
ALYSIA MARIE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
111 MACKENAN DR, CARY, NC 27511-7903
(919) 230-7783
Mailing address
741 WESTERN AVE APT D4, NASHVILLE, NC 27856-1128
(252) 567-1991
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
907244214
UNITES HEALTH CARE
NC
Enumeration date
08/07/2017
Last updated
08/07/2017
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