Individual
DIANA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11600 ELDRIDGE AVE, LAKE VIEW TERRACE, CA 91342-6506
(747) 239-8759
Mailing address
11600 ELDRIDGE AVE, LAKE VIEW TERRACE, CA 91342-6506
(747) 239-8759
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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