Provider Demographics
NPI:1467111526
Name:GREVE, MEGAN MARIE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:GREVE
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 1:301 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BOTKINS
Mailing Address - State:OH
Mailing Address - Zip Code:45306-1111
Mailing Address - Country:US
Mailing Address - Phone:937-877-6111
Mailing Address - Fax:
Practice Address - Street 1:123 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1023
Practice Address - Country:US
Practice Address - Phone:419-584-5906
Practice Address - Fax:567-890-0385
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0029033104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty