Provider Demographics
NPI:1396327854
Name:STEELE, GRAYCESARAH M
Entity type:Individual
Prefix:MS
First Name:GRAYCESARAH
Middle Name:M
Last Name:STEELE
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 1:5562 BLUE LAGOON LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9030
Mailing Address - Country:US
Mailing Address - Phone:614-360-8409
Mailing Address - Fax:
Practice Address - Street 1:5562 BLUE LAGOON LN
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9030
Practice Address - Country:US
Practice Address - Phone:614-360-8409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2518172172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker