Provider Demographics
NPI:1821545740
Name:MELENDEZ, NANCY ANALIZ
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANALIZ
Last Name:MELENDEZ
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:C2 CALLE B
Mailing Address - Street 2:GUARICO
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-4017
Mailing Address - Country:US
Mailing Address - Phone:787-242-3819
Mailing Address - Fax:
Practice Address - Street 1:C2 CALLE B
Practice Address - Street 2:GUARICO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4017
Practice Address - Country:US
Practice Address - Phone:787-242-3819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR117191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical