| NPI | 1972161750 |
|---|---|
| Former Name | ELIVIA MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149.027050) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150106870) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2024-11-12 |