Individual
MAITTEE GRANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1143 LONGWOOD OAKS BLVD, LAKELAND, FL 33811-2343
(813) 486-2696
Mailing address
1143 LONGWOOD OAKS BLVD, LAKELAND, FL 33811-2343
(813) 486-2696
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI1235
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G650540795150
DL
FL
Enumeration date
04/05/2021
Last updated
04/05/2021
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