Individual
ALBA NYDIA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
400 GLENDALE RD, HAVERTOWN, PA 19083-3152
(267) 471-1922
Mailing address
PO BOX 434, PRIMOS SECANE, PA 19018-0434
(267) 471-1922
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CW021736
PA
104100000X
Social Worker
SW127479
PA
Other
Enumeration date
01/13/2010
Last updated
04/08/2021
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