Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | NY |
NPI | 1023520939 |
---|---|
Provider Name | Dr. Rebecca Granda |
First Address | Asheville, NC 28813-4579 |
Second Address | Brooklyn, NY 11228-3619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2017 |
Last Update Date | 27/08/2021 |