Individual
KARLA M MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1726 BUCKLEY LN, PROVO, UT 84606-5031
(801) 373-6562
(801) 375-9225
Mailing address
1726 BUCKLEY LN, PROVO, UT 84606-5031
(801) 373-6562
(801) 375-9225
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6810875-3506
UT
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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