Provider Demographics
NPI:1952750705
Name:PARRIES, MIRANDA (PHD, ALC)
Entity Type:Individual
Prefix:PROF
First Name:MIRANDA
Middle Name:
Last Name:PARRIES
Suffix:
Gender:F
Credentials:PHD, ALC
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:MONIQUE
Other - Last Name:JOHNSON-PARRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 ANA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1749
Mailing Address - Country:US
Mailing Address - Phone:256-258-7777
Mailing Address - Fax:
Practice Address - Street 1:215 ANA DR
Practice Address - Street 2:SUITE A
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1749
Practice Address - Country:US
Practice Address - Phone:256-258-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-11
Last Update Date:2016-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2427A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health