Individual
MICHEELIN MIRANDA ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
736 S ROSE, MESA, AZ 85204-3717
(480) 208-4662
Mailing address
736 S ROSE, MESA, AZ 85204-3717
(480) 208-4662
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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