Individual
DR. CAITLIN MARIE MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
21 E 2ND ST, RIVERHEAD, NY 11901-4686
(631) 766-8702
Mailing address
5 HARRISON TER, EAST QUOGUE, NY 11942-4320
(917) 747-5022
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
023050
NY
103TC0700X
Clinical Psychologist
29705
CA
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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