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Contact Information

JENNIFER R GRUBA, PHD
2901 HUNTERS TRL
PORTAGE, WI53901-3403
 Phone: 608-742-5518
 Fax: 608-742-4087
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for JENNIFER R GRUBA · (Female)

NPI # 1033413646
Status Active
Credentials PHD
Entity Individual
Enumeration date 12/23/2010
Last updated 12/04/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • WI License # 5149-057
  • WI License # 867-124
  • WI Medicaid 1033413646
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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