Individual
BERENICE MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6639 N KEDZIE AVE, CHICAGO, IL 60645-4161
(773) 765-3120
Mailing address
6221 S TROY ST, CHICAGO, IL 60629-2607
(773) 896-5011
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IL
Other
Enumeration date
11/22/2023
Last updated
11/22/2023
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