Individual
JODY GRUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHP
Contact information
Practice address
4110 N WATER TOWER PL, MOUNT VERNON, IL 62864-6295
(224) 283-8876
(360) 718-8542
Mailing address
4110 N WATER TOWER PL, MOUNT VERNON, IL 62864-6295
(252) 702-7838
(618) 242-1150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
CB60975961
WA
Other
Enumeration date
10/07/2019
Last updated
09/13/2023
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