Individual
DR. MIA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
186 BEACON ST, BOSTON, MA 02116-1342
(617) 983-7346
Mailing address
186 BEACON ST, BOSTON, MA 02116-1342
(617) 983-7346
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8737
MA
Other
Enumeration date
08/16/2007
Last updated
08/16/2007
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