Individual
CATHERINE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCHW
Contact information
Practice address
1331 GUSDORF RD, TAOS, NM 87571-6282
(575) 758-3601
Mailing address
538 N PASEO DE ONATE, ESPANOLA, NM 87532-2618
(505) 753-7218
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
G-011
NM
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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