Provider Demographics
NPI:1457129421
Name:GRANTNER, ANNE MARIE
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:GRANTNER
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 1:54 KELSEY LN
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4557
Mailing Address - Country:US
Mailing Address - Phone:810-241-2110
Mailing Address - Fax:
Practice Address - Street 1:54 KELSEY LN
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4557
Practice Address - Country:US
Practice Address - Phone:810-241-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851103679104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker