Provider Demographics
NPI:1346642824
Name:GRAU, TOBIAH MARIE
Entity Type:Individual
Prefix:MRS
First Name:TOBIAH
Middle Name:MARIE
Last Name:GRAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11624 RAPHAEL PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2067
Mailing Address - Country:US
Mailing Address - Phone:513-236-0326
Mailing Address - Fax:
Practice Address - Street 1:11624 RAPHAEL PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-2067
Practice Address - Country:US
Practice Address - Phone:513-236-0326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRQ684184374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide