MEDICARE: NALLELY MIRANDA LPC

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
1	101Y00000X	Counselor	82340	TX

General Provider Information

NPI Number	:	1972437853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NALLELY MIRANDA LPC

Provider Business Mailing Address
First Line	:	8250 MEADOW RD APT 5239
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3771
Country	:	US
Telephone Number	:	469-286-6342
Fax Number	:

Provider Business Practice Location Address
First Line	:	8250 MEADOW RD APT 5239
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3771
Country	:	US
Telephone Number	:	972-454-9206
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ NALLELY MIRANDA LPC” Practice Location

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