Healthcare Provider Details

I. General information

NPI: 1902769243
Provider Name (Legal Business Name): GWENETH J SPENGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 BIEDE AVE
DEFIANCE OH
43512-2497
US

IV. Provider business mailing address

211 BIEDE AVE
DEFIANCE OH
43512-2408
US

V. Phone/Fax

Practice location:
  • Phone: 419-782-8856
  • Fax: 419-784-4506
Mailing address:
  • Phone: 419-782-8856
  • Fax: 419-784-4506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614097
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: