Provider Demographics
NPI:1972930188
Name:GRABLE, KATHRYN RENEE (BA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RENEE
Last Name:GRABLE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10100 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9056
Mailing Address - Country:US
Mailing Address - Phone:419-695-8010
Mailing Address - Fax:
Practice Address - Street 1:2555 S DIXIE DR STE 260
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-1542
Practice Address - Country:US
Practice Address - Phone:937-853-9061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator