Individual
ANDREW G MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LBA, BCBA
Contact information
Practice address
2919 S ELLSWORTH RD STE 115, MESA, AZ 85212-2165
(602) 579-7961
Mailing address
2919 S ELLSWORTH RD STE 115, MESA, AZ 85212-2165
(602) 579-7961
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66131
AZ
Other
Enumeration date
07/10/2019
Last updated
09/25/2024
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