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1780423582
MARK J MEDINA
LAS VEGAS, NM
NPI
1780423582
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2024-05-21
Last Update Date
2024-05-21
Business Address
MARK J MEDINA CSW
2301 7TH ST STE A
LAS VEGAS, NM 87701-4966
Phone number: 505-454-8079
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Mailing Address
MARK J MEDINA CSW
105 PASEO DEL CANON W STE A
TAOS, NM 87571-6943
Phone number: 575-737-5533
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