Individual
MIRANDA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9417 SAINT JOE RD, FORT WAYNE, IN 46835-9474
(260) 370-6573
Mailing address
6424 SPY GLASS RUN, FORT WAYNE, IN 46804-4232
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35002269A
IN
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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