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General NPI Number Information
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NPI Number | 1174217962
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Entity Type | Individual
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Provider Name | AMY GRUBB LSW
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Gender | Female
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 21 GEISINGER LN
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City | LEWISTOWN
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State | PA
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Zip | 17044-3400
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Country | US
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Telephone | 717-242-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 6047 OLD US HIGHWAY 322
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City | MILROY
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State | PA
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Zip | 17063-9427
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Country | US
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Telephone | 717-953-2622
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW140195
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License Number State | PA
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