Provider Demographics
NPI:1114028313
Name:DACEY, CHRISTINE MARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MARY
Last Name:DACEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 GRANDIN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-3418
Mailing Address - Country:US
Mailing Address - Phone:513-321-1729
Mailing Address - Fax:
Practice Address - Street 1:3800 VICTORY PARKWAY
Practice Address - Street 2:XAVIER UNIVERSITY
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45207-6511
Practice Address - Country:US
Practice Address - Phone:513-745-1033
Practice Address - Fax:513-745-3327
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3061103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical