Provider Demographics
NPI:1588802524
Name:GRAMAN, SARAH MARIE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:GRAMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:WEISGERBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS, IECE
Mailing Address - Street 1:123 PLEASANT RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2813
Mailing Address - Country:US
Mailing Address - Phone:859-640-0341
Mailing Address - Fax:
Practice Address - Street 1:123 PLEASANT RIDGE AVE
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-2813
Practice Address - Country:US
Practice Address - Phone:859-640-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000081158222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist