Individual
ISABEL MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
400 MARKET ST, CAMDEN, NJ 08102-1526
(856) 541-1700
(856) 541-4139
Mailing address
400 MARKET ST, CAMDEN, NJ 08102-1526
(856) 541-1700
(856) 541-4139
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC001634
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC001634
PC LICENSE
PA
Enumeration date
05/25/2007
Last updated
07/08/2007
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