Provider Demographics
NPI:1194429084
Name:GRUBB, JOSEPH (MS/CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:GRUBB
Suffix:
Gender:M
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 E ORMSBY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2624
Mailing Address - Country:US
Mailing Address - Phone:270-839-6940
Mailing Address - Fax:
Practice Address - Street 1:721 E ORMSBY AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2624
Practice Address - Country:US
Practice Address - Phone:270-839-6940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY138620235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist