Individual
MRS. ILENE ABIGAIL GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
1114 BENEFIELD BLVD, SUITE G, MILLERSVILLE, MD 21108
(410) 987-4301
Mailing address
7821 FAULKNER RD, SEVERN, MD 21144-3246
(240) 832-8430
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22505
MD
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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