Organization
FORWARD MENTAL HEALTH & WELLNESS
Active
Other names
Medina Psychiatry & Substance Abuse
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MEDINA CRNP (OWNER)
(410) 245-4474
Entity
Organization
Contact information
Practice address
9500 MEDICAL CENTER DR STE 432, LARGO, MD 20774-3716
(410) 245-4474
Mailing address
9500 MEDICAL CENTER DR STE 432, LARGO, MD 20774-3716
(410) 245-4474
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/05/2021
Last updated
01/05/2021
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