Provider Demographics
NPI:1386995991
Name:MIRALLES CARDONA, CRISTINA (MA, LPCC)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:MIRALLES CARDONA
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 ROBIE ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-2415
Mailing Address - Country:US
Mailing Address - Phone:651-222-0757
Mailing Address - Fax:
Practice Address - Street 1:381 ROBIE ST E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-2415
Practice Address - Country:US
Practice Address - Phone:651-222-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN503101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional