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Individual

ZEALENE GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
166 BOB THOMAS CIR, SANFORD, FL 32771-3094
(407) 878-9224
(407) 878-2230
Mailing address
166 BOB THOMAS CIR, SANFORD, FL 32771-3094
(407) 878-9224
(407) 878-2230

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
232966
FL
376J00000X
Homemaker
Primary
232966
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
677283896
FL
05
677283898
FL
Enumeration date
02/18/2013
Last updated
02/18/2013
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