Provider Demographics
NPI:1548923782
Name:DUNCAN, MIRANDA LEANE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:LEANE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 S POLK AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-4121
Mailing Address - Country:US
Mailing Address - Phone:318-259-4489
Mailing Address - Fax:
Practice Address - Street 1:2105 S POLK AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-4121
Practice Address - Country:US
Practice Address - Phone:318-259-4489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist