Individual
MS. MIRANDA LEAH KATTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. PA-C
Contact information
Practice address
3577 W 13 MILE RD STE 202A, ROYAL OAK, MI 48073-6710
(248) 551-0669
(248) 551-0058
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601007838
MI
363AM0700X
Medical Physician Assistant
Primary
5601007838
MI
Other
Enumeration date
07/14/2016
Last updated
04/04/2024
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