Individual
JULIA FERNANDES DE MIRANDA SOARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
4075 PARK AVE, MEMPHIS, TN 38111-7400
(901) 584-8281
Mailing address
5826 STONECREST DR, OLIVE BRANCH, MS 38654-0226
(901) 453-0322
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24374158
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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