Provider Demographics
NPI:1063801561
Name:GRUBER, JOCELYN D
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:D
Last Name:GRUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CRANBERRY RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4629
Mailing Address - Country:US
Mailing Address - Phone:724-372-4519
Mailing Address - Fax:
Practice Address - Street 1:175 CRANBERRY RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4629
Practice Address - Country:US
Practice Address - Phone:724-372-4519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst