Individual
MS. MIRANDA LYNETTE TINGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
903 ROSALIE DR, RUSTON, LA 71270-2732
(318) 245-0719
Mailing address
903 ROSALIE DR, RUSTON, LA 71270-2732
(318) 245-0719
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11184
LA
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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