Individual
CODY RYAN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5755 OBERLIN DR STE 300, SAN DIEGO, CA 92121-4717
(800) 249-1266
Mailing address
1301 E ORANGEWOOD AVE, ANAHEIM, CA 92805-6807
(800) 249-1266
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/29/2019
Last updated
03/29/2019
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