MEDICARE: MS. LOIS CHRISTINE GRACZ L.P.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	789	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184639536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LOIS CHRISTINE GRACZ L.P.C

Provider Business Mailing Address
First Line	:	6290 LEHMAN DR
Second Line	:	SUITE 202
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1471
Country	:	US
Telephone Number	:	719-528-2426
Fax Number	:	719-265-9314

Provider Business Practice Location Address
First Line	:	6290 LEHMAN DR
Second Line	:	SUITE 202
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1471
Country	:	US
Telephone Number	:	719-528-2426
Fax Number	:	719-265-9314

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/09/2007

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