Provider Demographics
NPI:1467336412
Name:GRISWOLD, MARIA ANTOINETTE
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANTOINETTE
Last Name:GRISWOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANTOINETTE
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1247 EASTGATE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-6919
Mailing Address - Country:US
Mailing Address - Phone:419-276-3244
Mailing Address - Fax:419-382-5008
Practice Address - Street 1:1247 EASTGATE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6919
Practice Address - Country:US
Practice Address - Phone:419-276-3244
Practice Address - Fax:419-382-5008
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide