Miranda Mae Moffat
Technician, Other in Dearborn, MI. Individual provider (NPI-1).
NPI number1669926796
StatusActive
Last updated in NPPESAug 5, 2016
Details
- NPI
- 1669926796
- Entity type
- Individual (NPI-1)
- Name
- Miranda Mae Moffat
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2016
- Last updated
- Aug 5, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
3231 S Gulley RdDearborn, MI 48124-4407
Phone 313-278-2327
Mailing address
620 Germantown PikeLafayette Hill, PA 19444-1810
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