Individual
STACIE STEWART MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
29849 SOUTH MAGNOLIA ST., LIVINGSTON, LA 70754-1130
(225) 686-7600
Mailing address
PO BOX 1130, LIVINGSTON, LA 70754-1130
(225) 686-7600
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z10890
LA
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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