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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649757956 | NPPES |
| Florida | MEDICAID | 104507400 |
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