Individual
MAYRA ROCIO MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1106 RIVERLANE DR, BRADLEY, IL 60915-1947
(815) 214-0962
Mailing address
1106 RIVERLANE DR, BRADLEY, IL 60915-1947
(815) 671-7092
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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