Individual
ANGELA RAE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2456 W 38TH ST, CHICAGO, IL 60632-1008
(773) 823-7743
Mailing address
PO BOX 388750, CHICAGO, IL 60638-8750
(773) 266-7621
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.013465
IL
Other
Enumeration date
04/05/2021
Last updated
04/05/2021
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