Healthcare Provider Details

I. General information

NPI: 1972681922
Provider Name (Legal Business Name): CHRISTOPHER AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/27/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S. JACKSON PARK DRIVE
SEYMOUR IN
47274
US

IV. Provider business mailing address

600 S. JACKSON PARK DRIVE
SEYMOUR IN
47274
US

V. Phone/Fax

Practice location:
  • Phone: 812-523-0386
  • Fax: 512-523-8416
Mailing address:
  • Phone: 812-523-0386
  • Fax: 512-523-8416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20041655A
License Number StateIN

VIII. Authorized Official

Name: DR. MYRIAM L GRAHAM
Title or Position: NEW OWNER AND HEAD PSYCHOLOGIST
Credential: PH.D., HSPP
Phone: 812-523-0386