Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT3304 | CO |
NPI | 1023394145 |
---|---|
Provider Name | Heidi Therese Graf |
First Address | Crested Butte, CO 81224-0000 |
Second Address | Crested Butte, CO 81224-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2011 |
Last Update Date | 03/11/2011 |