Individual
MS. MARYANN MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
192 3RD AVE, WESTWOOD, NJ 07675-2154
(631) 220-3833
Mailing address
714 A VE E, BAYONNE, NJ 07002
(631) 220-3833
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00165400
NJ
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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