Manuel J Medina

NPI #1003454307 in Oklahoma City, Oklahoma

Provider Information

NPI Number: 1003454307
Entity Type: Individual
Name: Manuel J Medina
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 17, 2019
Last Updated: Dec 17, 2019

Practice Location

Address: 2700 S SHARTEL AVE
City: Oklahoma City
State: Oklahoma
ZIP Code: 73109-2234
Phone: (405) 752-2264

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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