Provider Demographics
NPI:1073293379
Name:ALEMAN, MIRANDA K (OTR, OTD)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:K
Last Name:ALEMAN
Suffix:
Gender:F
Credentials:OTR, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W LEGEND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-5004
Mailing Address - Country:US
Mailing Address - Phone:512-466-3623
Mailing Address - Fax:
Practice Address - Street 1:211 W LEGEND OAKS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-5004
Practice Address - Country:US
Practice Address - Phone:512-466-3623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123489225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist