Organization
MIRALIFE TELE-THERAPIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNY N JINOR (AO)
(910) 805-2740
Entity
Organization
Contact information
Practice address
4315 50TH ST NW, WASHINGTON, DC 20016-4369
(910) 805-2740
(910) 939-1674
Mailing address
3434 KILDAIRE FARM RD, CARY, NC 27518-2277
(910) 805-2740
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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