Provider Information for 1588919013
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Mrs. CALLIE ANNE GRUENWALD M.S., LPC Candidate
Other Names:Former Name:Ms. CALLIE ANN ULM M.S., LPC CandidateSex: Female
NPI: 1588919013
Last Updated: 2013-05-09
Certification Date:
Certification Date:
Details
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NPI | 1588919013 | ||||||||
Enumeration Date | 2012-07-20 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 2800 SW 109TH ST OKLAHOMA CITY, OK 73170-2462 United States Phone: 405-606-1723 | Fax: | ||||||||
Primary Practice Address | 2800 SW 109TH ST OKLAHOMA CITY, OK 73170-2462 United States Phone: 405-606-1723 | Fax: | ||||||||
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