Individual
AMANDA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 MERRIMACK ST STE 141, LAWRENCE, MA 01843-1780
(508) 901-4686
Mailing address
43 SHERBURNE AVE UNIT 14, TYNGSBORO, MA 01879-1568
(857) 719-6440
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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