Individual
DR. DOUGLAS ALLAN GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1776 S JACKSON ST STE 204, DENVER, CO 80210
(720) 295-5853
(866) 466-5083
Mailing address
PO BOX 370448, DENVER, CO 80237-0448
(720) 295-5853
(866) 466-5083
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY 22678
CA
103TC0700X
Clinical Psychologist
Primary
PSY.0004669
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BX858A
MEDICARE PTAN
CA
Enumeration date
05/12/2009
Last updated
03/19/2020
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