Individual
MARIJO MEDINA VILLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14275 MIDWAY RD STE 260, ADDISON, TX 75001-3613
(944) 546-9665
Mailing address
14275 MIDWAY RD STE 260, ADDISON, TX 75001-3613
(469) 665-9445
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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