Jacquelyn Michelle Granda, LMHC, NCC
Counselor, Mental Health in Boca Raton, FL. Individual provider (NPI-1).
NPI number1629625843
StatusActive
Last updated in NPPESAug 22, 2019
Details
- NPI
- 1629625843
- Entity type
- Individual (NPI-1)
- Name
- Jacquelyn Michelle Granda
- Credential
- LMHC, NCC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 22, 2019
- Last updated
- Aug 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | MH17038 | FL | Yes |
Practice location
21301 Powerline Rd Ste 304Boca Raton, FL 33433-2391
Phone 561-902-8317
Mailing address
8267 Via LeonessaBoca Raton, FL 33433-2220
Phone 561-902-8317
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