Individual
MIRANDA IRENE PAINE-JESAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
21236 ORME ST, ABITA SPRINGS, LA 70420-3430
(972) 762-3403
Mailing address
21236 ORME ST, ABITA SPRINGS, LA 70420-3430
(972) 762-3403
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
09424
LA
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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