Richard Medina, LAC

NPI #1164132049 in Ridgefield Park, New Jersey

Provider Information

NPI Number: 1164132049
Entity Type: Individual
Name: Richard Medina, LAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: LAC
Enumeration Date: Dec 1, 2022
Last Updated: Dec 1, 2022

Practice Location

Address: 9 EUCLID AVE
City: Ridgefield Park
State: New Jersey
ZIP Code: 07660-1914
Phone: (201) 304-8716

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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