| NPI | 1467990804 |
|---|---|
| Former Name | EDITH MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 2928) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA APCC11553) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2022-09-16 |