Provider Demographics
NPI:1588028674
Name:MERCADO, IRMA IVETTE
Entity Type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:IVETTE
Last Name:MERCADO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:IRMA
Other - Middle Name:IVETTE
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:19 CALLE TULIPAN
Mailing Address - Street 2:MANUEL CORCHADO
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2722
Mailing Address - Country:US
Mailing Address - Phone:787-238-1317
Mailing Address - Fax:
Practice Address - Street 1:19 CALLE TULIPAN
Practice Address - Street 2:MANUEL CORCHADO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2722
Practice Address - Country:US
Practice Address - Phone:787-238-1317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14962355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant