Provider Demographics
NPI:1013168186
Name:CALHOUN, MIRANDA DEE X
Entity Type:Individual
Prefix:MS
First Name:MIRANDA
Middle Name:DEE
Last Name:CALHOUN
Suffix:X
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 1:5085 MERRITT DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1272
Mailing Address - Country:US
Mailing Address - Phone:720-495-1616
Mailing Address - Fax:
Practice Address - Street 1:5085 MERRITT DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1272
Practice Address - Country:US
Practice Address - Phone:720-495-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health