Individual
DOUG GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
466 W MAIN ST, WATERBURY, CT 06702-1123
(203) 591-8010
(203) 591-8586
Mailing address
350 FAIRFIELD AVE, SUITE 701, BRIDGEPORT, CT 06604-6014
(203) 336-5225
(203) 336-2851
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000395
CT
101YM0800X
Mental Health Counselor
000395
CT
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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