Provider Demographics
NPI:1487233086
Name:MELENDEZ, BRENDA LIZ (MSW)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:LIZ
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 8 BOX 1170
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731-9519
Mailing Address - Country:US
Mailing Address - Phone:939-295-9203
Mailing Address - Fax:
Practice Address - Street 1:CALLE REINA ISABEL
Practice Address - Street 2:44
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3722
Practice Address - Country:US
Practice Address - Phone:787-651-3522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR154811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical