Provider Demographics
NPI:1699597492
Name:GRUBBS, CAROLINE DAVIS
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:DAVIS
Last Name:GRUBBS
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 1:3278 WESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6266
Mailing Address - Country:US
Mailing Address - Phone:804-994-3394
Mailing Address - Fax:
Practice Address - Street 1:7225 BELL CREEK RD STE 256B
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3503
Practice Address - Country:US
Practice Address - Phone:804-994-3394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119010591225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics