Provider Demographics
NPI:1598151680
Name:GRUNDNER, JAIME
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:GRUNDNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:MARIE
Other - Last Name:CLAFLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:699 FARMHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-9402
Mailing Address - Country:US
Mailing Address - Phone:406-556-6500
Mailing Address - Fax:
Practice Address - Street 1:699 FARMHOUSE LN
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-9402
Practice Address - Country:US
Practice Address - Phone:406-556-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT116161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical