Individual
KENNETH DEGRAPHENREID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4800 E CAPITOL ST NE APT 405, WASHINGTON, DC 20019-5216
(202) 397-7044
Mailing address
3959 BLAINE ST NE, WASHINGTON, DC 20019-3334
(202) 841-9315
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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