Individual
BRENDA D MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12745 LONGHORNE DR, EASTVALE, CA 92880-8840
(909) 730-4662
Mailing address
12745 LONGHORNE DR, EASTVALE, CA 92880-8840
(909) 730-4662
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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