Individual
MS. CATHERINE MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7928 W HILTON AVE, PHOENIX, AZ 85043-7418
(623) 936-5250
Mailing address
3108 W. ROSE LANE, PHOENIX, AZ 85017
(623) 313-0003
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
3873
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
923997
AHCCCS ID NUMBER
AZ
Enumeration date
11/28/2006
Last updated
10/26/2012
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