Individual
MIRANDA SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310-1000
(910) 907-8922
Mailing address
2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310-0001
(910) 907-8922
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
734
WY
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
10/08/2018
Last updated
04/01/2025
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