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Individual

MRS. ELAINE MALLON GRUBB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PCC

Contact information

Practice address
161 S LIBERTY ST, POWELL, OH 43065-7619
(614) 789-0300
Mailing address
4837 INISHEER CT, DUBLIN, OH 43017-9170
(614) 395-2055
(614) 789-0300

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0800450
OH

Other

Enumeration date
12/26/2013
Last updated
12/26/2013
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