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General NPI Number Information
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NPI Number | 1124811955
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Entity Type | Individual
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Provider Name | MS. ASHLEY J MIRANDA
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Gender | Female
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Dates
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Enumeration Date | 05/24/2025
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Last Update Date | 05/24/2025
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Provider Practice Location Address
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Address Line | 625 MAIN RD
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City | TIVERTON
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State | RI
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Zip | 02878-1351
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Country | US
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Telephone | 401-816-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 98 BURCHARD AVE
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City | LITTLE COMPTON
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State | RI
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Zip | 02837-1601
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Country | US
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Telephone | 401-200-5268
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | CSW03276
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License Number State | RI
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