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General NPI Number Information
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NPI Number | 1427089671
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Entity Type | Individual
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Provider Name | KRISTIN ELIZABETH GRAPES PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 2910 BRIARCLIFF ROAD
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3176
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Country | US
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Telephone | 336-407-6764
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Fax |
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Provider Business Mailing Address
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Address Line | 2910 BRIARCLIFFE RD SUITE 604-B
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3176
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Country | US
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Telephone | 336-407-6764
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Fax | 336-773-0332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 673
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License Number State | NC
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