Provider Demographics
NPI:1114961919
Name:GRUNEWALD, SHEILA S (OT, CHT)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:S
Last Name:GRUNEWALD
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:MISS
Other - First Name:SHEILA
Other - Middle Name:S
Other - Last Name:KUESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:6 SW 260TH RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-7593
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1807 W BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2501
Practice Address - Country:US
Practice Address - Phone:660-826-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004834225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
32907041OtherBCBS KC
MOMA4370007OtherMEDICARE PTAN