Individual
MS. MIRANDA LEAH DEMIRJIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1046 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 332-3106
Mailing address
161 PORTER LN, ORANGE, CT 06477-3033
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236148
—
CT
Enumeration date
09/28/2017
Last updated
09/28/2017
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