Provider Demographics
NPI:1346031952
Name:GRUENDEMANN, JERAMIAH (PSYD)
Entity type:Individual
Prefix:DR
First Name:JERAMIAH
Middle Name:
Last Name:GRUENDEMANN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 PAPERMAKER DR
Mailing Address - Street 2:
Mailing Address - City:KIMBERLY
Mailing Address - State:WI
Mailing Address - Zip Code:54136-1856
Mailing Address - Country:US
Mailing Address - Phone:920-858-1389
Mailing Address - Fax:
Practice Address - Street 1:1575 ALLOUEZ AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-5625
Practice Address - Country:US
Practice Address - Phone:920-858-1389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist