Individual
ANTONELLA STEPHANIE MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6538 NETHERSEAL AVE, LAS VEGAS, NV 89139-5352
(702) 338-0120
Mailing address
6538 NETHERSEAL AVE, LAS VEGAS, NV 89139-5352
(702) 338-0120
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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