Individual
MIRIAM BORAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3601 GREEN RD, BEACHWOOD, BEACHWOOD, OH 44122-5725
(216) 645-1003
Mailing address
3601 GREEN RD, BEACHWOOD, BEACHWOOD, OH 44122-5725
(216) 645-1003
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6205
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000389939
ANTHEM BC & BS
OH
01
—
P00301310
RAILROAD MEDICARE
OH
Enumeration date
09/20/2006
Last updated
04/07/2023
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