Individual provider · Type 1 NPI

Elleis Miranda, BS

Developmental Therapist · Chicago, IL

NPI number 1164048567 Active

Practice location

304 N Loomis St
Chicago, IL 60607-1147

Call (312) 243-8487 Map

Other practice locations

  • 1409 W Carroll Ave, Chicago, IL 60607-1105 · (312) 733-0883

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1164048567

Elleis Miranda, BS's National Provider Identifier is 1164048567, issued on Jun 22, 2020. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Chicago, IL. The record was last updated on May 9, 2022.