Individual
KYRA MIRANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
716 15TH ST, DURHAM, NC 27705-3902
(919) 294-6723
Mailing address
114 GRESHAM AVE, DURHAM, NC 27704-4208
(206) 499-0803
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19786
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19786
MASSAGE AND BODYWORK LICENSE
NC
Enumeration date
09/23/2021
Last updated
09/23/2021
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