Provider Demographics
NPI:1922267038
Name:GRAWE, HEATHER HOLEN (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:HOLEN
Last Name:GRAWE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 ELM ST N
Mailing Address - Street 2:
Mailing Address - City:CANNON FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55009-2112
Mailing Address - Country:US
Mailing Address - Phone:507-298-0407
Mailing Address - Fax:
Practice Address - Street 1:300 MILL ST W
Practice Address - Street 2:
Practice Address - City:CANNON FALLS
Practice Address - State:MN
Practice Address - Zip Code:55009-2045
Practice Address - Country:US
Practice Address - Phone:507-298-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1009106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist