Organization Name: | JEFFREY M. GRAN, PSY.D., P.A. |
NPI Number: | 1285814566 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY M. GRAN (PRESIDENT) |
Mailing Address: | 1050 Ne 125th St North Miami |
State: | FL US |
Postal Code: | 331615805 |
Phone Number: | 9545582870 |
Fax Number: | 9548937829 |
NPI Enumeration Date: | 11/05/2007 |
NPI Last Update Date: | 11/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PY 5683 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |