Individual
MELYSANDRA CORAE GRANJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 BROADWAY STE 204, KISSIMMEE, FL 34741-5705
(321) 946-9041
Mailing address
850 W SOUTHPORT RD, KISSIMMEE, FL 34746-2615
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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