Individual
MIRA LOTFALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1426 E 820 N, OREM, UT 84097-5481
(385) 309-1038
Mailing address
1765 ALA MOANA BLVD APT 1487, HONOLULU, HI 96815-1440
(818) 288-7204
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
03/25/2022
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