| Jacquelyn Granda, Llc | |
|
21301 Powerline Rd Ste 304 Boca Raton FL 33433-2391 | |
| (561) 299-1549 | |
| Not Available |
| Full Name | Jacquelyn Granda, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 21301 Powerline Rd Ste 304, Boca Raton, Florida |
| Authorized Official Name and Position | Jacquelyn Michelle Granda (OWNER) |
| Authorized Official Contact | 5619028317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquelyn Granda, Llc 21301 Powerline Rd Ste 304 Boca Raton FL 33433-2391 Ph: (561) 299-1549 | Jacquelyn Granda, Llc 21301 Powerline Rd Ste 304 Boca Raton FL 33433-2391 Ph: (561) 299-1549 |
| NPI Number | 1528618501 |
|---|---|
| Provider Enumeration Date | 09/12/2019 |
| Last Update Date | 09/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528618501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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