Individual
MIRAHERTZ ENOW ATEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5420 N MORGAN ST APT 103, ALEXANDRIA, VA 22312-3306
(571) 501-4579
Mailing address
5420 N MORGAN ST APT 103, ALEXANDRIA, VA 22312-3306
(571) 501-4579
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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