Provider Demographics
NPI:1780019364
Name:ROJAS, MIRIAN A (SLPA)
Entity Type:Individual
Prefix:MISS
First Name:MIRIAN
Middle Name:A
Last Name:ROJAS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19100 VENTURA BLVD STE Q
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3238
Mailing Address - Country:US
Mailing Address - Phone:818-708-7704
Mailing Address - Fax:
Practice Address - Street 1:19100 VENTURA BLVD STE Q
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3238
Practice Address - Country:US
Practice Address - Phone:818-708-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2602355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant