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Provider Information for 1922616887


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Ms. AMANDA GRANT SW 18293


Sex: Female

NPI: 1922616887
Last Updated: 2021-06-15
Certification Date: 2021-06-15

Details

NameValue
NPI1922616887
Enumeration Date2020-07-16
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1890 NW 127TH ST
MIAMI, FL 33167-2175
United States

Phone: 786-319-7339 | Fax:
 
Primary Practice Address 1890 NW 127TH ST
MIAMI, FL 33167-2175
United States

Phone: 786-319-7339 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalFLSW18293
No 390200000X - Student in an Organized Health Care Education/Training Program FLISW13554