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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 Candidate

Sex: Female

NPI: 1588919013
Last Updated: 2013-05-09
Certification Date:

Details

NameValue
NPI1588919013
Enumeration Date2012-07-20
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
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:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - Professional