Individual
MIRANDA PAIGE MUSSOLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
351 TENNY ST, BLOOMSBURG, PA 17815-3264
(570) 802-3099
Mailing address
592 HAZLE ST, WESTON, PA 18256-9800
(570) 926-1513
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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