Individual
TIA DANIELLE JONES MEDINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 WEDGEFIELD CT, NEW CASTLE, DE 19720-3754
(302) 563-0642
Mailing address
12 WEDGEFIELD CT, NEW CASTLE, DE 19720-3754
(302) 563-0642
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0001751
DE
Other
Enumeration date
02/25/2020
Last updated
03/11/2020
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