# SANDRA LUTZEN-MEDINA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1518336411
- **Gender:** F
- **Credential:** LMT, WHE

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | 010705-1 | NY | Yes |
| 225700000X | Massage Therapist | 010705-1 | NY | — |

## Other

- **Enumeration date:** 09/21/2015
- **Last updated:** 01/25/2017