Provider Demographics
NPI:1871026930
Name:GRUBB, LAURA MELTON (PHD, BCBA-D, LBA)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MELTON
Last Name:GRUBB
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11500 CRONRIDGE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2261
Mailing Address - Country:US
Mailing Address - Phone:410-517-1113
Mailing Address - Fax:410-517-2113
Practice Address - Street 1:11500 CRONRIDGE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2261
Practice Address - Country:US
Practice Address - Phone:410-517-1113
Practice Address - Fax:410-517-2113
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA040103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst