Individual
MICHELLE MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1635 AURORA CT FL 4, AURORA, CO 80045-2541
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY.0005930
CO
2084N0400X
Neurology Physician
11368146-2501
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/18/2014
Last updated
10/30/2022
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