Individual
OMAR LEE MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
155 EARL ST, PLAINVILLE, GA 30733-9672
(770) 354-2912
(706) 234-4943
Mailing address
155 EARL ST, PLAINVILLE, GA 30733-9672
(770) 354-2912
(706) 234-4943
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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