Individual
NICOLE ELIZABETH MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 341-5779
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A18422
NC
101YP2500X
Professional Counselor
Primary
A18422
NC
Other
Enumeration date
02/21/2023
Last updated
02/28/2023
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