Provider Demographics
NPI:1699393637
Name:MEDINA, AIMEE (BBS)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:MEDINA
Suffix:
Gender:F
Credentials:BBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20212 CHAMPION FOREST DR STE 700-196
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8780
Mailing Address - Country:US
Mailing Address - Phone:832-257-3778
Mailing Address - Fax:949-655-7811
Practice Address - Street 1:10103 EARLINGTON MANOR DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7459
Practice Address - Country:US
Practice Address - Phone:281-883-8048
Practice Address - Fax:949-655-7811
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor