Doctor Name: | CHRISTOPHER JON GRAVETT |
NPI Number: | 1295066447 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 7014686-3501 |
Business Practice Address: | 53 S 700 E Price, UT - 845013128 |
Business Phone Number: | 4356101896 |
Business Fax Number: | |
Mailing Address: | 53 S 700 E, PRICE |
State: | UT |
Postal Code: | 845013128 |
Phone Number: | 4356101896 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2010 |
NPI Last Update Date: | 01/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 7014686-3501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |