Individual
JAQUILINE MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1910 PACIFIC AVE SUITE 2000, #1957, DALLAS, TX 75201
(215) 774-3527
Mailing address
1910 PACIFIC AVE STE 2000, DALLAS, TX 75201-4540
(215) 774-3527
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
COUI9732
ID
Other
Enumeration date
07/31/2024
Last updated
05/30/2026
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