Individual
MIRANDA SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
24 W SERGEANT COURT DR STE 204, SARATOGA SPRINGS, UT 84045-5809
(801) 987-6733
Mailing address
24 W SERGEANT COURT DR STE 204, SARATOGA SPRINGS, UT 84045-5809
(801) 987-6733
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
111437
TX
235Z00000X
Speech-Language Pathologist
Primary
11660935-4102
UT
Other
Enumeration date
02/28/2019
Last updated
09/18/2020
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