Provider Demographics
NPI:1437833969
Name:GRAHAM, LE'DAISHA LENN
Entity Type:Individual
Prefix:
First Name:LE'DAISHA
Middle Name:LENN
Last Name:GRAHAM
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 1:401 GREENGATE CIR APT O
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-7447
Mailing Address - Country:US
Mailing Address - Phone:803-634-0176
Mailing Address - Fax:
Practice Address - Street 1:141 CHESTERFIELD ST
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-4501
Practice Address - Country:US
Practice Address - Phone:803-502-1718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist