Provider Demographics
NPI:1447098090
Name:ZINK, MIRANDA NICOLE (MS)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:NICOLE
Last Name:ZINK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S BETHLEHEM PIKE APT 2
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5844
Mailing Address - Country:US
Mailing Address - Phone:267-474-0194
Mailing Address - Fax:
Practice Address - Street 1:100 S BETHLEHEM PIKE APT 2
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5844
Practice Address - Country:US
Practice Address - Phone:267-474-0194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health