Individual
MS. MIRANDA SHORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
1660 FORT ST, TRENTON, MI 48183-2003
(734) 304-4159
Mailing address
1660 FORT ST, TRENTON, MI 48183-2003
(734) 304-4159
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362010026
MI
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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