Mariana Medina

NPI #1104423037 in Dexter, New Mexico

Provider Information

NPI Number: 1104423037
Entity Type: Individual
Name: Mariana Medina
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Oct 5, 2020
Last Updated: Oct 5, 2020

Practice Location

Address: 6488 BEARD ST
City: Dexter
State: New Mexico
ZIP Code: 88230-9733
Phone: (575) 840-4219

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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