Provider Demographics
NPI:1629467774
Name:MELENDEZ, NOEMI (PSYCHOLOGIST MA)
Entity Type:Individual
Prefix:MRS
First Name:NOEMI
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:PSYCHOLOGIST MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-02 BOX 6500
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-608-1415
Mailing Address - Fax:
Practice Address - Street 1:CALLE BALDORIOTY DE CASTRO #47
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-608-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3007103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist