Individual
CHRISTY MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 747-2409
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 747-2409
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB515609
NC
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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