Individual
RAEANN ELIZABETH MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFT, LPC
Contact information
Practice address
400 E 6TH ST, PARKVILLE, MO 64152-3703
(816) 587-4100
Mailing address
400 E 6TH ST, PARKVILLE, MO 64152-3703
(816) 587-4100
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2008003019
MO
106H00000X
Marriage & Family Therapist
2008018147
MO
Other
Enumeration date
03/21/2007
Last updated
01/12/2012
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