Individual
MISS JACQUELINE YARIBEL MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20239 W HILTON AVE, BUCKEYE, AZ 85326-9039
(602) 626-0551
Mailing address
20239 W HILTON AVE, BUCKEYE, AZ 85326-9039
(602) 626-0551
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
13577
AZ
2355S0801X
Speech-Language Assistant
Primary
SLPA13577
AZ
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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