Individual
MIRANDA J MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
510 REDDICK ST, MISHAWAKA, IN 46544-1669
(517) 575-8745
Mailing address
510 REDDICK ST, MISHAWAKA, IN 46544-1669
(517) 575-8745
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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