Individual
DENISHA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, IBCLC
Contact information
Practice address
2701 N WHEELER ST, OKLAHOMA CITY, OK 73127-1439
(405) 201-2473
Mailing address
2701 N WHEELER ST, OKLAHOMA CITY, OK 73127-1439
(405) 201-2473
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
174400000X
Specialist
—
—
174N00000X
Lactation Consultant (Non-RN)
Primary
L-127057
—
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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