Individual
MIRANDA RENE BLACKBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 3RD ST, MUSKEGON, MI 49441-2170
(231) 722-9622
Mailing address
1103 BERNARD ST APT 732, DENTON, TX 76201-7194
(713) 494-9586
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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