Provider Demographics
NPI:1043477664
Name:GRIESER, SARA MARY
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARY
Last Name:GRIESER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MARY
Other - Last Name:HOHEISEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7175 SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371-1135
Mailing Address - Country:US
Mailing Address - Phone:763-631-9151
Mailing Address - Fax:
Practice Address - Street 1:7175 SPRUCE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371-1135
Practice Address - Country:US
Practice Address - Phone:763-631-9151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child