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General NPI Number Information
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NPI Number | 1245054790
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Entity Type | Organization
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Legal Business Name | MIRANDA J VILLARD COUNSELING, LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 6100 OAK TREE BLVD STE 200
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City | INDEPENDENCE
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State | OH
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Zip | 44131-6914
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Country | US
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Telephone | 216-309-0902
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Fax |
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Provider Business Mailing Address
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Address Line | 7318 TRAYMORE AVE
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City | BROOKLYN
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State | OH
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Zip | 44144-3236
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Country | US
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Telephone | 440-391-1852
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MIRANDA VILLARD
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Credential | LPCC
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Telephone | 216-309-0902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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