Adrianna Elaisa Medina
Recreational Therapist Assistant in East Lansing, MI. Individual provider (NPI-1).
NPI number1013501329
StatusActive
Last updated in NPPESFeb 26, 2021
Details
- NPI
- 1013501329
- Entity type
- Individual (NPI-1)
- Name
- Adrianna Elaisa Medina
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 26, 2021
- Certification date
- Feb 18, 2021
- Last updated
- Feb 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 226000000X | Recreational Therapist Assistant | – | – | Yes |
Practice location
2775 E Lansing DrEast Lansing, MI 48823-7755
Phone 855-407-7575
Mailing address
2775 E Lansing DrEast Lansing, MI 48823-7755
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