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Individual

HEIDI ANNETTE DIRKSE-GRAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1998 SKYPARK DR STE 102, MEDFORD, OR 97504-5395
(541) 500-1022
(202) 788-6366
Mailing address
1998 SKYPARK DR STE 102, MEDFORD, OR 97504-5395
(541) 500-1022
(202) 788-6366

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3861
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1497461669
NPI NUMERATOR
05
500711141
OR
Enumeration date
01/07/2016
Last updated
10/28/2025
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