Individual
JILLIAN ROSE MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1525 E 23RD ST S, INDEPENDENCE, MO 64055
(816) 836-1177
Mailing address
1525 E 23RD ST S, INDEPENDENCE, MO 64055-1670
(816) 836-1177
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2011028876
MO
Other
Enumeration date
06/05/2013
Last updated
08/18/2018
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