Individual
MIRANDA DEMPEWOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4574 EXCALIBUR CT, COLORADO SPRINGS, CO 80917-1356
(941) 416-1301
Mailing address
4574 EXCALIBUR CT, COLORADO SPRINGS, CO 80917-1356
(941) 416-1301
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/10/2016
Last updated
12/10/2016
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