| Doctor Name: | DR. JOSEPH JOHN GRACA |
| NPI Number: | 1235149295 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 4394 |
| Business Practice Address: | 48 Main Street Suite 15 Bisbee, AZ - 856031805 |
| Business Phone Number: | 5202490352 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1667 48 Main St., Suite 15 BISBEE |
| State: | AZ |
| Postal Code: | 856031805 |
| Phone Number: | 5202490352 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 03/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 4394 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |