Provider Demographics
NPI:1710309554
Name:DEGRAFF, LISA (LMFT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DEGRAFF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 LONG HILL RD # 2
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3823
Mailing Address - Country:US
Mailing Address - Phone:860-861-1453
Mailing Address - Fax:860-446-6918
Practice Address - Street 1:333 LONG HILL RD # 2
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3823
Practice Address - Country:US
Practice Address - Phone:860-861-1453
Practice Address - Fax:860-446-6918
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist