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1972025906
MARK STANLEY MEDINA
EASTHAMPTON, MA
NPI
1972025906
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-07-11
Last Update Date
2017-07-11
Business Address
MARK STANLEY MEDINA
179 NORTHAMPTON ST
EASTHAMPTON, MA 01027-1057
Phone number: 413-588-5555
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Mailing Address
MARK STANLEY MEDINA
12 CAROL ST
LUDLOW, MA 01056-2110
Phone number: 413-531-8907
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