Individual
MISS SHENNA YVONNE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LMBT
Contact information
Practice address
8731 BRAMPTON DRIVE, CHARLOTTE, NC 28215
(704) 806-7510
Mailing address
8731 BRAMPTON DRIVE, CHARLOTTE, NC 28215
(704) 806-7510
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
L002360
NC
133NN1002X
Nutrition Education Nutritionist
L002360
NC
133V00000X
Registered Dietitian
Primary
L002360
NC
225700000X
Massage Therapist
06188
NC
Other
Enumeration date
03/02/2009
Last updated
06/20/2019
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