Provider Demographics
NPI:1598454803
Name:OLMEDA, MELGRID
Entity Type:Individual
Prefix:
First Name:MELGRID
Middle Name:
Last Name:OLMEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND TORRES NAVEL # 402B
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-3509
Mailing Address - Country:US
Mailing Address - Phone:689-227-9681
Mailing Address - Fax:
Practice Address - Street 1:20 CALLE PROL 25 DE JULIO APT 402B
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3522
Practice Address - Country:US
Practice Address - Phone:689-227-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health