Individual
TERESA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4950 MC NUTT RD, SUNLAND PARK, NM 88063
(505) 882-6200
Mailing address
P.O. DRAWER 70, ANTHONY, NM 88021
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3115
NM
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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