Provider Demographics
NPI:1821866047
Name:GRAGG, DINAH DOWNEY (MA, LSSP, LPA)
Entity Type:Individual
Prefix:
First Name:DINAH
Middle Name:DOWNEY
Last Name:GRAGG
Suffix:
Gender:F
Credentials:MA, LSSP, LPA
Other - Prefix:
Other - First Name:DINAH
Other - Middle Name:WHITNEY
Other - Last Name:DOWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LSSP, LPA
Mailing Address - Street 1:127 RIDGEHAVEN PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3419
Mailing Address - Country:US
Mailing Address - Phone:210-663-7558
Mailing Address - Fax:
Practice Address - Street 1:7410 BLANCO RD STE 400
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4394
Practice Address - Country:US
Practice Address - Phone:210-838-5351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31464103TS0200X
TX31587103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool