Individual
KATHLEEN MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12380 DEPAUL DRIVE, BRIDGETON, MO 63044-2511
(314) 447-9700
Mailing address
5100 BISCHOFF AVE, SAINT LOUIS, MO 63110-3104
(508) 439-9041
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016029273
MO
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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