Individual
STACY GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
655 DENBIGH BLVD, NEWPORT NEWS, VA 23608-4478
(757) 890-0905
Mailing address
655 DENBIGH BLVD, NEWPORT NEWS, VA 23608-4478
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006721
VA
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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