Basic Information
Provider Information
NPI: 1144662016
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUENTHER
FirstName: SHARON
MiddleName: ELIZABETH
NamePrefix: MRS.
NameSuffix:  
Credential: MSW, LISW-S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 30 E APPLE ST
Address2: SUITE 5254A
City: DAYTON
State: OH
PostalCode: 454092939
CountryCode: US
TelephoneNumber: 9372084200
FaxNumber: 9372084205
Practice Location
Address1: 30 E APPLE ST
Address2: SUITE 5254A
City: DAYTON
State: OH
PostalCode: 454092939
CountryCode: US
TelephoneNumber: 9372084200
FaxNumber: 9372084205
Other Information
ProviderEnumerationDate: 07/22/2013
LastUpdateDate: 12/12/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XI5669OHY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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