Provider Demographics
NPI:1750733499
Name:DEGRAFF, DEBORAH A (LIC AC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:A
Last Name:DEGRAFF
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:A
Other - Last Name:DEGRAFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LIC AC
Mailing Address - Street 1:21 VALERIE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3748
Mailing Address - Country:US
Mailing Address - Phone:802-279-6829
Mailing Address - Fax:
Practice Address - Street 1:21 VALERIE AVE
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3748
Practice Address - Country:US
Practice Address - Phone:802-279-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091.0000025171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist