Healthcare Provider Details

I. General information

NPI: 1093634313
Provider Name (Legal Business Name): LATONYA GRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 RODMAN ST NW APT 306
WASHINGTON DC
20008-3152
US

IV. Provider business mailing address

108 MICHIGAN AVE NE APT 12E
WASHINGTON DC
20017-1030
US

V. Phone/Fax

Practice location:
  • Phone: 202-369-3939
  • Fax:
Mailing address:
  • Phone: 202-487-9235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number376J00000X
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: