Provider Demographics
NPI:1609198977
Name:MEJIAS, SANDINID (SLP)
Entity Type:Individual
Prefix:
First Name:SANDINID
Middle Name:
Last Name:MEJIAS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CALLE VICTORIA
Mailing Address - Street 2:LAS GRANJAS
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-5060
Mailing Address - Country:US
Mailing Address - Phone:787-599-9288
Mailing Address - Fax:
Practice Address - Street 1:21 CALLE VICTORIA
Practice Address - Street 2:LAS GRANJAS
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-5060
Practice Address - Country:US
Practice Address - Phone:787-599-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR804235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist