Provider Demographics
NPI:1023394145
Name:GRAF, HEIDI THERESE (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:THERESE
Last Name:GRAF
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 ELK AVENUE
Mailing Address - Street 2:
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-0000
Mailing Address - Country:US
Mailing Address - Phone:970-901-5642
Mailing Address - Fax:970-349-1049
Practice Address - Street 1:405 ELK AVENUE
Practice Address - Street 2:
Practice Address - City:CRESTED BUTTE
Practice Address - State:CO
Practice Address - Zip Code:81224-0000
Practice Address - Country:US
Practice Address - Phone:970-901-5642
Practice Address - Fax:970-349-1049
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT3304225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand