Individual
JESSICA SUE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
100 KENDALL DR, LAMAR, CO 81052-3901
(719) 384-5446
(719) 336-7453
Mailing address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 587-1060
(719) 587-1525
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
21791
CO
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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