Individual
JOHANNA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8901 BLUEWATER RD NW, ALBUQUERQUE, NM 87121-2024
(505) 833-7540
Mailing address
PO BOX 25704, ALBUQUERQUE, NM 87125-0704
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
M-09360
NM
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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