Healthcare Provider Details

I. General information

NPI: 1013901651
Provider Name (Legal Business Name): JAMES A GRUBMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 MONTAGUE CITY RD SUITE 100
TURNERS FALLS MA
01376-1830
US

IV. Provider business mailing address

356 MONTAGUE CITY RD SUITE 100
TURNERS FALLS MA
01376-1830
US

V. Phone/Fax

Practice location:
  • Phone: 413-775-0557
  • Fax:
Mailing address:
  • Phone: 413-775-0557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7419
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: