Individual
MIRANDA VILLAREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
5203 JUAN TABO BLVD NE STE 2A, ALBUQUERQUE, NM 87111-2691
(505) 266-6121
Mailing address
4425 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87111-2681
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-1228
NM
Other
Enumeration date
10/22/2018
Last updated
01/22/2026
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