Individual
MIRACLE JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 STATE ST STE 700, ALBANY, NY 12207-1707
(631) 385-7780
Mailing address
1400 WASHINGTON AVE, ALBANY, NY 12222-0100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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