Individual
MRS. KAYLA LAUREN MIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
300 N 18TH ST, PHOENIX, AZ 85006-4103
(602) 340-8717
Mailing address
15001 N 60TH DR., GLENDALE, AZ 85306
(802) 779-1772
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-23099
AZ
101YP2500X
Professional Counselor
LPC-23099
AZ
Other
Enumeration date
12/29/2017
Last updated
06/25/2024
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