Individual
ANGELICA SEFERINA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4840 GRASSELLI ST, EAST CHICAGO, IN 46312-3503
(219) 397-1085
Mailing address
526 EMLYN PL, EAST CHICAGO, IN 46312-2648
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/03/2025
Last updated
12/03/2025
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