Provider Demographics
NPI:1821127390
Name:ORIETA, MIRIAM A (MA)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:A
Last Name:ORIETA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10570 S US HIGHWAY 1
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5606
Mailing Address - Country:US
Mailing Address - Phone:772-380-9972
Mailing Address - Fax:772-380-9976
Practice Address - Street 1:10570 S US HIGHWAY 1
Practice Address - Street 2:SUITE 200
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5606
Practice Address - Country:US
Practice Address - Phone:772-380-9972
Practice Address - Fax:772-380-9976
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker