Individual
DR. LAURIE BLUM GRUNEBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
62 TRUMBULL ST, NEW HAVEN, CT 06510-1022
(203) 776-3667
(203) 772-1482
Mailing address
62 TRUMBULL ST, NEW HAVEN, CT 06510-1022
(203) 776-3667
(203) 772-1482
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001747
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060001747CT01
ANTHEM BC & BS
CT
01
—
134296
VALUE OPTIONS
CT
Enumeration date
10/26/2006
Last updated
07/08/2007
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