| NPI | 1669197893 |
|---|---|
| Former Name | GINA MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19669) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2023-10-17 |