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NPI Code Detail

MEDICARE: MIRANDA BAILEY NEIDER

MEDICARE: MIRANDA BAILEY NEIDER
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 Worker13405079-3502UT

General Provider Information

NPI Number : 1396631032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA BAILEY NEIDER
Provider Business Mailing Address
First Line : 1234 W SOUTH JORDAN PKWY STE B2
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-4649
Country : US
Telephone Number : 801-821-4501
Fax Number :
Provider Business Practice Location Address
First Line : 1234 W SOUTH JORDAN PKWY STE B2
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-4649
Country : US
Telephone Number : 801-821-4501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2025
Last Update Date : 06/17/2025

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Directions to “ MIRANDA BAILEY NEIDER ” Practice Location

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