Provider Demographics
NPI:1609505429
Name:FREYRE-MARTINEZ, MELIZU (QHMS)
Entity Type:Individual
Prefix:MRS
First Name:MELIZU
Middle Name:
Last Name:FREYRE-MARTINEZ
Suffix:
Gender:F
Credentials:QHMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2811
Mailing Address - Country:US
Mailing Address - Phone:419-740-3022
Mailing Address - Fax:
Practice Address - Street 1:111 CLINTON ST
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2811
Practice Address - Country:US
Practice Address - Phone:419-740-3022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator