Provider Demographics
NPI:1124566351
Name:GRUENEMEYER, KATHRYN R (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:R
Last Name:GRUENEMEYER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 GREENACRE DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-4074
Mailing Address - Country:US
Mailing Address - Phone:567-208-7329
Mailing Address - Fax:
Practice Address - Street 1:27 ST LAWRENCE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-8312
Practice Address - Country:US
Practice Address - Phone:419-447-7203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist