Individual
MIRANDA SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
91658
CA
1041S0200X
School Social Worker
Primary
ASW134359
CA
Other
Enumeration date
10/22/2019
Last updated
03/04/2026
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