Individual
ALEXIS MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 DORRANCE ST, PROVIDENCE, RI 02903-2018
(877) 418-2978
Mailing address
63 CAMPION AVE, TIVERTON, RI 02878-2516
(774) 994-5718
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
RI
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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