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Individual

MRS. STEPHANIE MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
712 N MONROE AVE, SEDGWICK, KS 67135-9492
(316) 772-5185
Mailing address
1829 E 53RD ST S, WICHITA, KS 67216-3341
(316) 990-2763

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01305
KS

Other

Enumeration date
02/19/2018
Last updated
02/19/2018
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