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1326603127
MARITZA DIONNE MIRANDA 08/29/8708
FAIRBANKS, AK
NPI
1326603127
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-05-07
Last Update Date
2020-03-06
Business Address
MARITZA DIONNE MIRANDA 08/29/8708
542 4TH AVE STE B101
FAIRBANKS, AK 99701-4707
Phone number: 907-374-1097
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Mailing Address
MARITZA DIONNE MIRANDA 08/29/8708
542 4TH AVE STE B101
FAIRBANKS, AK 99701-4707
Phone number: 907-374-1097
Copy
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