Individual
JENNIFER MARIE GRUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
20377 RICHARD AVE, SOUTH BEND, IN 46637-2946
(574) 307-6007
Mailing address
20377 RICHARD AVE, SOUTH BEND, IN 46637-2946
(574) 307-6007
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33007097A
IN
1041C0700X
Clinical Social Worker
Primary
34010349A
IN
Other
Enumeration date
11/11/2021
Last updated
07/13/2023
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