Provider Demographics
NPI:1891889663
Name:ALVAREZ-MELENDEZ, YIDDISH MARIE (M A, PHD (C))
Entity Type:Individual
Prefix:
First Name:YIDDISH
Middle Name:MARIE
Last Name:ALVAREZ-MELENDEZ
Suffix:
Gender:F
Credentials:M A, PHD (C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#22 CALLE SOL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-677-6065
Mailing Address - Fax:
Practice Address - Street 1:#22 CALLE SOL
Practice Address - Street 2:SUITE 1
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730
Practice Address - Country:US
Practice Address - Phone:787-677-6065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA101YM0800X
PR2714103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health