Provider Demographics
NPI:1386183523
Name:M. DEBORAH GRUEN, PH.D.
Entity Type:Organization
Organization Name:M. DEBORAH GRUEN, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-221-8000
Mailing Address - Street 1:4 ELWIL DR
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3706
Mailing Address - Country:US
Mailing Address - Phone:203-221-8000
Mailing Address - Fax:
Practice Address - Street 1:4 ELWIL DR
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3706
Practice Address - Country:US
Practice Address - Phone:203-221-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty