Doctor Name: | JENNIFER GRUBB |
NPI Number: | 1225423312 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., LAC, NCC |
License Number: | 37AC00153900 |
Business Practice Address: | 615 Hope Rd Eatontown, NJ - 077241277 |
Business Phone Number: | 7323890697 |
Business Fax Number: | |
Mailing Address: | 4214 Central Ave, ABERDEEN |
State: | NJ |
Postal Code: | 077471079 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/06/2015 |
NPI Last Update Date: | 04/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 37AC00153900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |