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Individual

VIVIAN MARINA MIRANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAMFT

Contact information

Practice address
80 MAIN ST STE 410, WEST ORANGE, NJ 07052-5441
(856) 772-5809
Mailing address
134 HUMBOLDT ST FL 1, EAST RUTHERFORD, NJ 07073-1713
(201) 705-0717

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
37FA00002200
NJ

Other

Enumeration date
05/10/2019
Last updated
05/10/2019
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