| Doctor Name: | MRS. OLGA LIDIA MIRANDA HERNANDEZ |
| NPI Number: | 1013269554 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 41 Voltaire Ave Henderson, NV - 890026553 |
| Business Phone Number: | 7028451332 |
| Business Fax Number: | 7025582305 |
| Mailing Address: | 41 Voltaire Ave, HENDERSON |
| State: | NV |
| Postal Code: | 890026553 |
| Phone Number: | 7028451332 |
| Fax Number: | 7025582305 |
| NPI Enumeration Date: | 10/08/2012 |
| NPI Last Update Date: | 10/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TM1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Mental Retardation & Developmental Disabilities |
| Taxonomy Definition: | |