Provider Demographics
NPI:1497628861
Name:GRANT, JAMIE MICHELLE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHELLE
Last Name:GRANT
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 1:259 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2103
Mailing Address - Country:US
Mailing Address - Phone:419-315-7504
Mailing Address - Fax:
Practice Address - Street 1:905 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3670
Practice Address - Country:US
Practice Address - Phone:567-525-4100
Practice Address - Fax:419-408-3497
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTD798944171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator