=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699602227
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANINE GRANT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2026
-----------------------------------------------------
Last Update Date | 05/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7108 S KANNER HWY
-----------------------------------------------------
City | STUART
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34997-7462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-832-6727
-----------------------------------------------------
Fax | 772-675-9100
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2442 NW 7TH ST
-----------------------------------------------------
City | OKEECHOBEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34972-2317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-623-2829
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------