Provider Demographics
NPI:1700197993
Name:GRONEWOLLER, REGINA LOUISE (LMSW)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:LOUISE
Last Name:GRONEWOLLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19855 NEUCHATEL RD
Mailing Address - Street 2:
Mailing Address - City:ONAGA
Mailing Address - State:KS
Mailing Address - Zip Code:66521-9812
Mailing Address - Country:US
Mailing Address - Phone:785-456-3532
Mailing Address - Fax:
Practice Address - Street 1:19855 NEUCHATEL RD
Practice Address - Street 2:
Practice Address - City:ONAGA
Practice Address - State:KS
Practice Address - Zip Code:66521-9812
Practice Address - Country:US
Practice Address - Phone:785-456-3532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7773104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker