Provider Demographics
NPI:1437423365
Name:GRAND PSYCHOLOGY CORP.
Entity Type:Organization
Organization Name:GRAND PSYCHOLOGY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAND
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D, ABPP
Authorized Official - Phone:305-596-4663
Mailing Address - Street 1:9150 SW 87TH AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2319
Mailing Address - Country:US
Mailing Address - Phone:305-596-4663
Mailing Address - Fax:305-596-6947
Practice Address - Street 1:9150 SW 87TH AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2319
Practice Address - Country:US
Practice Address - Phone:305-596-4663
Practice Address - Fax:305-596-6947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5822174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty