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Individual

MIRANDA SHELBY SHUPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5300 WESTVIEW DR STE 200, FREDERICK, MD 21703-8303
(240) 242-5865
Mailing address
1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 33134-4108
(844) 244-1818

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
106S00000X
Behavior Technician

Other

Enumeration date
09/13/2024
Last updated
07/21/2025
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