Individual
AMANDA CHRISTINE DUFFELL MIRADOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1260 MORENA BLVD STE 100, SAN DIEGO, CA 92110-3850
(619) 398-0355
Mailing address
1260 MORENA BLVD STE 100, SAN DIEGO, CA 92110-3850
(619) 398-0355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/23/2021
Last updated
07/26/2021
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