Individual
KIANNE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 BARNEY DR, JOLIET, IL 60435-5271
(815) 725-2194
Mailing address
913 BRIARCLIFF DR, MINOOKA, IL 60447-8831
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.014861
IL
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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