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General NPI Number Information
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NPI Number | 1699393637
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Entity Type | Individual
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Provider Name | AIMEE MEDINA BBS
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Gender | Female
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 10103 EARLINGTON MANOR DR
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City | SPRING
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State | TX
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Zip | 77379-7459
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Country | US
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Telephone | 281-883-8048
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Fax | 949-655-7811
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Provider Business Mailing Address
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Address Line | 20212 CHAMPION FOREST DR STE 700-196
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City | SPRING
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State | TX
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Zip | 77379-8780
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Country | US
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Telephone | 832-257-3778
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Fax | 949-655-7811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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