Individual
MIRANDA GRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1652 KELLER PKWY STE 100, KELLER, TX 76248-3876
(817) 562-3111
Mailing address
1908 THISTLE HILL DR APT 16309, FORT WORTH, TX 76110-7433
(775) 842-2096
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
218244
TX
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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