| NPI | 1871687491 |
|---|---|
| Former Name | MIRANDA K MOYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 4787) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 180) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-12-28 |