Individual
INNAEL TODD MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, LPC, LMHC
Contact information
Practice address
1119 MORNINGSIDE DR NE, ALBUQUERQUE, NM 87110-6172
(720) 230-3326
Mailing address
1119 MORNINGSIDE DR NE, ALBUQUERQUE, NM 87110-6172
(720) 230-3326
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACC-7097
CO
101YM0800X
Mental Health Counselor
CTB-2023-0229
NM
101YM0800X
Mental Health Counselor
Primary
LPC.0020508
CO
Other
Enumeration date
06/16/2011
Last updated
04/08/2024
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