Jennifer R Gruba, PHD is a
Psychologist - Clinical based in Portage, Wisconsin. Jennifer R Gruba is licensed to practice in Wisconsin (license number 5149-057) and her current practice location is
2901 Hunters Trl, Portage, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(608) 742-5518.
NPI number for Jennifer R Gruba is 1033413646 and her current mailing address is 710 N. Webb Ave, Reedsburg, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1033413646.
Healthcare Provider's Profile
Full Name | Jennifer R Gruba |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 2901 Hunters Trl, Portage, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1033413646
- Provider Enumeration Date: 12/23/2010
- Last Update Date: 12/04/2024
Medical Identifiers
Medical identifiers for Jennifer R Gruba such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1033413646 | NPI | - | NPPES |
1033413646 | Medicaid | WI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
106H00000X | Marriage & Family Therapist | 867-124 (Wisconsin) | Secondary |
103TC0700X | Psychologist - Clinical | 5149-057 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer R Gruba is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jennifer R Gruba, PHD 710 N. Webb Ave, Reedsburg, WI 53959 Ph: (608) 524-5151 | Jennifer R Gruba, PHD 2901 Hunters Trl, Portage, WI 53901-3403 Ph: (608) 742-5518 |
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