Individual
BRANDON MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1808 BORDEAUX BLVD APT V, BURLINGTON, KY 41005-8569
(571) 340-1893
Mailing address
1808 BORDEAUX BLVD APT V, BURLINGTON, KY 41005-8569
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-241828
KY
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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