Individual
DR. HARRY MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1900 W POLK ST, 840, CHICAGO, IL 60612-3723
(718) 419-3344
Mailing address
1900 W POLK ST, 840, CHICAGO, IL 60612-3723
(718) 419-3344
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-009158
IL
103TC0700X
Clinical Psychologist
PY9254
FL
Other
Enumeration date
09/21/2015
Last updated
04/27/2021
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