Provider Demographics
NPI:1952649618
Name:ROSA, MELISSA (PHD IN PSYCHOLOGY)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:ROSA
Suffix:
Gender:F
Credentials:PHD IN PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CALLE ADELINA HERNANDEZ
Mailing Address - Street 2:LAS CUEVAS
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-7202
Mailing Address - Country:US
Mailing Address - Phone:787-344-4489
Mailing Address - Fax:
Practice Address - Street 1:6 CALLE ADELINA HERNANDEZ
Practice Address - Street 2:LAS CUEVAS
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-7202
Practice Address - Country:US
Practice Address - Phone:787-344-4489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004748103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical