Basic Information
| Provider Information | |||||||||
| NPI: | 1588850101 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRUNER | ||||||||
| FirstName: | SARAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 STRANAHAN SQ | ||||||||
| Address2: | SUITE 414 | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436041447 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 7320 STATE HIGHWAY 108 | ||||||||
| Address2: | STE. A | ||||||||
| City: | WAUSEON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435678200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193353732 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2007 | ||||||||
| LastUpdateDate: | 09/18/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | S0700220 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.