Individual
ALYSSA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7278 HIGHWAY 518, RANCHOS DE TAOS, NM 87557-8830
(575) 613-3144
Mailing address
PO BOX 3100, RANCHOS DE TAOS, NM 87557-3100
(575) 613-3144
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
CTB-2025-0155
NM
Other
Enumeration date
07/13/2022
Last updated
07/18/2025
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