Medina, Camilla

Medina, Camilla is an sole proprietor health care provider with primary practice located at 1315 Amos St , Dallas TX 75212-5202. She recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as her primary health care specialty. Medina, Camilla can be contacted via phone (214) 773-2879.

Contact Information

Primary practice address
1315 Amos St Dallas TX 75212-5202
Phone: (214) 773-2879
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1295246916
LBN Legal business name Medina, Camilla
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2017
Last updated Oct 20th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers