Provider Demographics
NPI:1154678431
Name:GRAHAM-ABRAO, LUANA
Entity Type:Individual
Prefix:
First Name:LUANA
Middle Name:
Last Name:GRAHAM-ABRAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4448 SWEET STONE PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6220
Mailing Address - Country:US
Mailing Address - Phone:702-205-6526
Mailing Address - Fax:
Practice Address - Street 1:4448 SWEET STONE PL
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6220
Practice Address - Country:US
Practice Address - Phone:702-205-6526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner