Individual
DANE ALBERT GRUVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3285 E SPARROW AVE, FLAGSTAFF, AZ 86004-7794
(928) 220-1997
Mailing address
3285 E SPARROW AVE, FLAGSTAFF, AZ 86004-7794
(928) 220-1997
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-11561
AZ
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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