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General NPI Number Information
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NPI Number | 1659154771
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Entity Type | Individual
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Provider Name | MIRANDA ESSA
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Gender | Female
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 1101 N LAKE DESTINY RD STE 265
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City | MAITLAND
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State | FL
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Zip | 32751-7116
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Country | US
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Telephone | 689-777-5065
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Fax |
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Provider Business Mailing Address
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Address Line | 3440 N GOLDENROD RD APT 317
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City | WINTER PARK
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State | FL
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Zip | 32792-8767
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Country | US
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Telephone | 813-997-1083
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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 | 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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