Provider Demographics
NPI:1295025195
Name:VELEZ HERNANDEZ, JAKELINE D (MS-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JAKELINE
Middle Name:D
Last Name:VELEZ HERNANDEZ
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 483
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0483
Mailing Address - Country:US
Mailing Address - Phone:787-975-9285
Mailing Address - Fax:
Practice Address - Street 1:F-18 URBANIZACION VILLA SERAL
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-975-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1003235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist