Individual
KRISTIN ALVIS MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1869 CREST RD, MARYVILLE, TN 37804-4304
(865) 210-7825
Mailing address
508 PEBBLE CREEK RD, KNOXVILLE, TN 37918-9754
(540) 908-8631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5735
TN
Other
Enumeration date
09/02/2022
Last updated
09/02/2022
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