| NPI | 1174101604 |
|---|---|
| Former Name | MIRANDA L COBB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103441) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |