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NPI Code Detail

MEDICARE: MIRANDA ALDRICH LMSW

MEDICARE: MIRANDA ALDRICH LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerNY

General Provider Information

NPI Number : 1396492088
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA ALDRICH LMSW
Provider Business Mailing Address
First Line : 111 HOSPITAL DR
Second Line :
City : UTICA
State : NY
Zip : 13502-2517
Country : US
Telephone Number : 315-801-8534
Fax Number :
Provider Business Practice Location Address
First Line : 37 MAIN ST
Second Line :
City : WHITESBORO
State : NY
Zip : 13492-1034
Country : US
Telephone Number : 315-624-8563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2022
Last Update Date : 01/16/2025

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Directions to “ MIRANDA ALDRICH LMSW” Practice Location

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