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General NPI Number Information
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NPI Number | 1144586850
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Entity Type | Individual
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Provider Name | MARY G. MIRANDA WHITE
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Gender | Female
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 8671 WOLFF CT SUITE 220-C
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City | WESTMINSTER
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State | CO
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Zip | 80031-3609
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Country | US
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Telephone | 720-485-7945
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Fax |
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Provider Business Mailing Address
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Address Line | 10859 W 70TH AVE
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City | ARVADA
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State | CO
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Zip | 80004-1306
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Country | US
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Telephone | 720-485-7945
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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