Individual
MIRANDA IRENE LACANNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1547 30TH AVE S, MOORHEAD, MN 56560-5149
(218) 287-4338
Mailing address
1547 30TH AVE S, MOORHEAD, MN 56560-5149
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/25/2024
Last updated
02/20/2026
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