Individual
MIRANDA ELLEN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3920 W CHARLESTON BLVD STE Y, LAS VEGAS, NV 89102-1633
(818) 894-2273
(818) 357-2505
Mailing address
3800 DALECREST DR UNIT 1061, LAS VEGAS, NV 89129-1795
(715) 587-2381
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
35288
CA
235Z00000X
Speech-Language Pathologist
6546-154
WI
235Z00000X
Speech-Language Pathologist
Primary
SP-3652
NV
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
07/16/2026
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