Individual
JESSICA ANGELICA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5540 W IOWA ST, TUCSON, AZ 85757-9353
(520) 578-9026
Mailing address
5540 W IOWA ST, TUCSON, AZ 85757-9353
(520) 578-9026
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
8797
AZ
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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