Provider Demographics
NPI:1942223359
Name:GRAND, CRISTINA (PSYDABPP)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:GRAND
Suffix:
Gender:F
Credentials:PSYDABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5822174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist