Individual
JACQUELINE E. GRUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED., LPC
Contact information
Practice address
4335 SUNRAY AVE, CHESAPEAKE, VA 23321-2625
(757) 485-9349
(757) 465-3639
Mailing address
4335 SUNRAY AVE, CHESAPEAKE, VA 23321-2625
(757) 485-9349
(757) 465-3639
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701008645
VA
Other
Enumeration date
10/08/2019
Last updated
10/18/2023
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