Provider Demographics
NPI:1679200430
Name:MIRANDA GONZALEZ, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:MIRANDA GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 VIA CANGREJOS
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4347
Mailing Address - Country:US
Mailing Address - Phone:939-599-1080
Mailing Address - Fax:
Practice Address - Street 1:5025 VIA CANGREJOS
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4347
Practice Address - Country:US
Practice Address - Phone:939-599-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist