Individual
MARY JOSEPHINE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1817 N 7TH ST, PHOENIX, AZ 85006-2100
(602) 257-3755
Mailing address
6358 W HATCHER RD, GLENDALE, AZ 85302-4022
(602) 229-1030
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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