Provider Demographics
NPI:1851589444
Name:FLORES, MIRANDA LENAY (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:LENAY
Last Name:FLORES
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 HIGH PLATEAU DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-5875
Mailing Address - Country:US
Mailing Address - Phone:972-992-8585
Mailing Address - Fax:
Practice Address - Street 1:3134 HIGH PLATEAU DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-5875
Practice Address - Country:US
Practice Address - Phone:972-992-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist