| Doctor Name: | CHRISTOPHER IVEY PATRICK |
| NPI Number: | 1366672560 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW |
| License Number: | SW 4796 |
| Business Practice Address: | 113 Howie Walters Rd Hurlburt Field, FL - 325445668 |
| Business Phone Number: | 8508814237 |
| Business Fax Number: | |
| Mailing Address: | 5 Lewis Dr, HURLBURT FIELD |
| State: | FL |
| Postal Code: | 325441005 |
| Phone Number: | 8508814237 |
| Fax Number: | |
| NPI Enumeration Date: | 07/22/2009 |
| NPI Last Update Date: | 07/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW 4796 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |