Individual
JONALYS LOPEZ MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSP, PSYD
Contact information
Practice address
2100 N MAIN ST # 304, CROWN POINT, IN 46307-1877
(888) 837-5440
(574) 546-1999
Mailing address
2100 N MAIN ST # 304, CROWN POINT, IN 46307-1877
(888) 837-5440
(574) 546-1999
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
20044079A
IN
Other
Enumeration date
05/18/2026
Last updated
05/20/2026
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