Individual
DANIELLE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
307 RIDGE ST STE 102, TONGANOXIE, KS 66086-9310
(913) 845-6122
Mailing address
1199 RIDGE CIR APT A, TONGANOXIE, KS 66086-9317
(870) 279-1104
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC03940-T
KS
101YP2500X
Professional Counselor
Primary
LPC04030
KS
101YS0200X
School Counselor
3992621634
KS
101YS0200X
School Counselor
5651054
AR
Other
Enumeration date
11/01/2021
Last updated
01/19/2023
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