Individual
COURTNEY MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 RIVER ST STE 302, HOBOKEN, NJ 07030-5619
(973) 291-2142
Mailing address
45 MEADOWLANDS PKWY UNIT 323, SECAUCUS, NJ 07094-2971
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00543100
NJ
221700000X
Art Therapist
21-045
NJ
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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