Individual
ASHLEY MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1751 RIVER RUN STE 200, FORT WORTH, TX 76107-6670
(817) 886-7667
Mailing address
1301 ANGLICAN DR, ARLINGTON, TX 76002-3740
(323) 600-7869
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-262206
TX
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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