Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1023351657 |
---|---|
Provider Name | Dr. James A Mcgruder |
First Address | Clementon, NJ 08021-5622 |
Second Address | Clementon, NJ 08021-5622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2013 |
Last Update Date | 02/04/2013 |