Provider Demographics
NPI:1447450150
Name:GRANJA, CATALINA Y (MSW)
Entity type:Individual
Prefix:MS
First Name:CATALINA
Middle Name:Y
Last Name:GRANJA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 SE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2319
Mailing Address - Country:US
Mailing Address - Phone:954-463-2273
Mailing Address - Fax:954-779-1643
Practice Address - Street 1:1001 NW 70TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-6028
Practice Address - Country:US
Practice Address - Phone:954-463-2273
Practice Address - Fax:954-779-1643
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 48381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical