Provider Demographics
NPI:1598306722
Name:MUNOZ-GRANDES, MARIA (MSC, MED, MA)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:MUNOZ-GRANDES
Suffix:
Gender:F
Credentials:MSC, MED, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2101
Mailing Address - Country:US
Mailing Address - Phone:215-880-2211
Mailing Address - Fax:
Practice Address - Street 1:714 S 15TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-2101
Practice Address - Country:US
Practice Address - Phone:215-880-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-29
Last Update Date:2019-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist