Individual
MRS. JILL LAUREN MIRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5525 TWIN KNOLLS RD, SUITE 327, COLUMBIA, MD 21045-3266
(410) 992-9149
(410) 992-9921
Mailing address
3200 TIMBERFIELD LN, BALTIMORE, MD 21208-4422
(410) 486-8188
(410) 992-9921
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3014
CO
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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