Individual
ERICA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17195 CLEVELAND RD, SOUTH BEND, IN 46635-1415
(574) 277-0274
Mailing address
17195 CLEVELAND RD, SOUTH BEND, IN 46635-1415
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/27/2020
Last updated
08/24/2023
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