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Individual

JOHN A MIRANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LCDC

Contact information

Practice address
110 E HOUSTON ST, SAN ANTONIO, TX 78205-2990
(210) 414-4327
(210) 451-0492
Mailing address
5300 ENCANTA ST APT 402, SAN ANTONIO, TX 78233-6459
(726) 300-4948
(210) 451-0492

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
115868
TX
103TC1900X
Counseling Psychologist
115868
TX

Other

Enumeration date
07/21/2019
Last updated
04/18/2021
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