Individual
MICHELLE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12103 S 29TH ST, BELLEVUE, NE 68123-1404
(909) 246-8896
Mailing address
14210 ARBOR ST, OMAHA, NE 68144-2385
(531) 999-1133
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
3747P1801X
NE
Other
Enumeration date
02/08/2025
Last updated
02/08/2025
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