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Individual
SUSAN ELAINE GRUBB
Active
Individual
SUSAN ELAINE GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC008798
PA
103K00000X
Behavior Analyst
BH000563
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103428940
—
PA
Enumeration date
07/07/2014
Last updated
07/02/2019
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