Provider Demographics
NPI:1447871538
Name:HARMAN, MIRANDA (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MIRANDA
Middle Name:
Last Name:HARMAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 MOCKINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2709
Mailing Address - Country:US
Mailing Address - Phone:512-743-6271
Mailing Address - Fax:512-743-6271
Practice Address - Street 1:5900 BALCONES DR # 24960
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:282-051-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115190235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14276792OtherASHA
TX115190OtherTDLR SPEECH PATHOLOGIST LICENSE