Healthcare Provider Details
I. General information
NPI: 1033038617
Provider Name (Legal Business Name): CHRISTOPHER GREGORY PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3201 E OAKLAWN DR
MUNCIE IN
47303-9403
US
IV. Provider business mailing address
3201 E OAKLAWN DR
MUNCIE IN
47303-9403
US
V. Phone/Fax
- Phone: 765-749-8041
- Fax:
- Phone: 765-749-8041
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: