Individual
MARIA LUCIANO MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6361 BRAYBOURNE PL, OLIVE BRANCH, MS 38654-6563
(901) 767-1040
Mailing address
6361 BRAYBOURNE PL, OLIVE BRANCH, MS 38654-6563
(901) 767-1040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000001086
TN
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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