Individual
CHARLOTTE GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5215 NORTH O'CONNOR BOULEVARD, 1100, IRVING, TX 75039
(469) 928-6710
Mailing address
4225 ARCADY AVE, DALLAS, TX 75205-3701
(469) 955-5125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
61494
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
08/21/2018
Last updated
09/17/2021
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