Provider Demographics
NPI:1184426355
Name:DURBIN, MIRANDA LIN
Entity type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:LIN
Last Name:DURBIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2289 AND 2293 NC, 24-87 HWY
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326
Mailing Address - Country:US
Mailing Address - Phone:910-500-7783
Mailing Address - Fax:
Practice Address - Street 1:2289 AND 2293 NC, 24-87 HWY
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326
Practice Address - Country:US
Practice Address - Phone:910-500-7783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician