Provider Demographics
NPI:1679986186
Name:GRAMME, HEATHER R (MSW, MSG)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:R
Last Name:GRAMME
Suffix:
Gender:F
Credentials:MSW, MSG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 TIMBERLINE RD
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-8430
Mailing Address - Country:US
Mailing Address - Phone:949-610-2045
Mailing Address - Fax:
Practice Address - Street 1:1901 TIMBERLINE RD
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-8430
Practice Address - Country:US
Practice Address - Phone:949-610-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CALCSW869251041C0700X
CA171M500000X1041C0700X
TX1103621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical