Provider Demographics
NPI:1346652047
Name:MIRANDA, PITAGORAS ALI (MFT LICENSE)
Entity Type:Individual
Prefix:
First Name:PITAGORAS
Middle Name:ALI
Last Name:MIRANDA
Suffix:
Gender:M
Credentials:MFT LICENSE
Other - Prefix:
Other - First Name:PITAGORAS
Other - Middle Name:ALI
Other - Last Name:MIRANDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:28710 FOX LYNN DR FL 2
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2761
Mailing Address - Country:US
Mailing Address - Phone:914-424-3562
Mailing Address - Fax:
Practice Address - Street 1:9401 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1407
Practice Address - Country:US
Practice Address - Phone:713-970-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002196106H00000X
TX205351106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist