Individual
DR. LISA ANTOENETTE MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY. D.
Contact information
Practice address
62 CALLE COMERCIO, PONCE, PR 00730-5003
(787) 901-4425
Mailing address
62 CALLE COMERCIO, PONCE, PR 00730-5003
(787) 901-4425
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1880
PR
Other
Enumeration date
01/23/2009
Last updated
02/20/2009
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