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Individual

ANITA B GANTNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
2500 METROHEALTH DR, MHMC-PM&R, CLEVELAND, OH 44109-1900
(216) 778-7799
Mailing address
2500 METROHEALTH DR, MHMC-PM&R, CLEVELAND, OH 44109-1900
(216) 778-7799

Taxonomy

Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
4399
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0861385
OH
01
2726468400
BWC
OH
Enumeration date
07/06/2006
Last updated
07/08/2007
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