Individual
MIRIAM AMY GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
841 SORIN ST APT 2H, SOUTH BEND, IN 46617-2066
(402) 216-9739
Mailing address
841 SORIN ST APT 2H, SOUTH BEND, IN 46617-2066
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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