Individual
LOURDES MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2266 S DOBSON RD STE 200, MESA, AZ 85202-6412
(480) 757-8090
Mailing address
PO BOX 258831, OKLAHOMA CITY, OK 73125-8831
(720) 961-3764
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20123852
AZ
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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