Individual
MR. ANTONIO C MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
5900 S LAKE FOREST DR, SUITE 300, MCKINNEY, TX 75070-2193
(469) 708-7151
Mailing address
5900 S LAKE FOREST DR, SUITE 300, MCKINNEY, TX 75070-2193
(469) 708-7151
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
104550
CA
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
49505
CA
Other
Enumeration date
04/04/2008
Last updated
11/30/2016
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