Grant, Chenelle

Grant, Chenelle is an individual health care provider with primary practice located at 4670 Lipscomb St Ne Ste 10 , Palm Bay FL 32905-2927. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Grant, Chenelle can be contacted via phone (813) 906-6203.

Contact Information

Primary practice address
4670 Lipscomb St Ne Ste 10 Palm Bay FL 32905-2927
Phone: (813) 906-6203
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X Florida
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-21-51835 Florida

Profile Details

NPI number 1649757956
LBN Legal business name Grant, Chenelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2018
Last updated Jun 28th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649757956 NPPES
Florida MEDICAID 104507400

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