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Individual

ALICIA M MIRANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, COTA (RET)

Contact information

Practice address
4949 MEADOWS RD STE 140, LAKE OSWEGO, OR 97035-3156
(503) 305-7244
(503) 305-8849
Mailing address
20070 LARKSPUR LN APT 66, WEST LINN, OR 97068-2381
(727) 686-6848

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA 14848
FL
225700000X
Massage Therapist
Primary
24185
OR
225700000X
Massage Therapist
MA41682
FL

Other

Enumeration date
04/28/2010
Last updated
04/27/2025
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