| NPI | 1215318407 |
|---|---|
| Former Name | MIRANDA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P009610) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC c010934) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2017-09-21 |