Individual
GINA A GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
562 ROCKY COVE LN, DENTON, NC 27239-7270
(336) 250-9966
Mailing address
562 ROCKY COVE LN, DENTON, NC 27239-7270
(336) 250-9966
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1055984
NC
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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