Organization
EMILY MEDINA, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY MEDINA (LCSW)
(203) 446-6486
Entity
Organization
Contact information
Practice address
2 IVY BROOK RD, SHELTON, CT 06484-6416
(203) 446-6486
Mailing address
50 MORNINGSIDE DR, ANSONIA, CT 06401-1312
(203) 446-6486
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007837
CT
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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