Individual
DR. TATIANA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
810 SCENIC HWY STE A, PENSACOLA, FL 32503-6866
(850) 733-6430
Mailing address
790 VETERANS WAY, PENSACOLA, FL 32507-1000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY10505
FL
103TC0700X
Clinical Psychologist
Primary
PY10505
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY10505
PSYCHOLOGIST
FL
Enumeration date
07/15/2019
Last updated
11/06/2024
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