Individual
MIRANDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC, LCDC, NCC
Contact information
Practice address
408 N FLAG ST, PHARR, TX 78577-3754
(956) 381-2736
Mailing address
5623 S ALAMO RD, EDINBURG, TX 78542-4485
(956) 381-2736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
86581
TX
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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