Individual
FERNANDO MANUEL MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC-A
Contact information
Practice address
8007 N POINT BLVD STE A, WINSTON SALEM, NC 27106-3268
(866) 700-1606
Mailing address
8007 N POINT BLVD STE A, WINSTON SALEM, NC 27106-3268
(866) 700-1606
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A16200
NC
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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