Individual
BERNADINE JOANN MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 HOTSPRINGS BLVD, LAS VEGAS, NM 87701-2737
(505) 425-6786
(505) 425-6787
Mailing address
PO BOX 2737, LAS VEGAS, NM 87701-2737
(505) 425-6786
(505) 425-6787
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0107321
NM
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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