Doctor Name: | PAIGE GRUEN |
NPI Number: | 1114332822 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 119 W Market St Columbia City, IN - 467252311 |
Business Phone Number: | 2602488176 |
Business Fax Number: | 2602482366 |
Mailing Address: | P.o Box 497, WARSAW |
State: | IN |
Postal Code: | 46580 |
Phone Number: | 5742677169 |
Fax Number: | |
NPI Enumeration Date: | 06/23/2014 |
NPI Last Update Date: | 06/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |