Provider Demographics
NPI:1205642873
Name:GRAIF, CHLOE JO
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:JO
Last Name:GRAIF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 BASSETT DR STE 103
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6223
Mailing Address - Country:US
Mailing Address - Phone:507-351-1034
Mailing Address - Fax:
Practice Address - Street 1:1821 BASSETT DR STE 103
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6223
Practice Address - Country:US
Practice Address - Phone:507-351-1034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst