Individual
MIKAYLA MIRANDA
Active
Individual
MIKAYLA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13528
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13528
MASSACHUSETTS BOARD OF ALLIED HEALTH PROFESSIONALS
MA
01
—
5419
DEPARTMENT OF PUBLIC HEALTH
CT
Enumeration date
05/11/2020
Last updated
05/11/2020
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