Provider Demographics
NPI:1679612493
Name:DEGRAFF, CHRISTOPHER DARRELL (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DARRELL
Last Name:DEGRAFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 FAIRVIEW DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-5389
Mailing Address - Country:US
Mailing Address - Phone:775-887-1817
Mailing Address - Fax:
Practice Address - Street 1:343 FAIRVIEW DR STE 104
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5389
Practice Address - Country:US
Practice Address - Phone:775-887-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPSY0203103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling