Individual
MISS MIRANDA LACE PRESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5550 OLD SHELL RD, MOBILE, AL 36608-3039
(251) 287-2242
Mailing address
5550 OLD SHELL RD, MOBILE, AL 36608-3039
(251) 287-2242
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-211098
AL
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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