Individual
ALICE MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1852 LOCKHILL SELMA RD STE 108, SAN ANTONIO, TX 78213-1500
(210) 271-7411
(210) 271-9414
Mailing address
5134 GWENDA LEA ST, SAN ANTONIO, TX 78242-2416
(210) 955-3796
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14074
TX
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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