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Individual
DR. MILDRED MEDINA
Active
Individual
DR. MILDRED MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY21221
CA
103TC0700X
Clinical Psychologist
Primary
PY 60037300
WA
Other
Enumeration date
07/11/2008
Last updated
11/02/2009
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