Individual
GINAY GRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
466 OLD HOOK RD, EMERSON, NJ 07630-1396
(201) 342-4004
Mailing address
14 CANAL RD, TOWACO, NJ 07082-1401
(201) 449-9346
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00512300
NJ
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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