Provider Demographics
NPI:1023439684
Name:COLON MELENDEZ, MINERLIZ (MS, PHL)
Entity type:Individual
Prefix:
First Name:MINERLIZ
Middle Name:
Last Name:COLON MELENDEZ
Suffix:
Gender:F
Credentials:MS, PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 CARR 2
Mailing Address - Street 2:CENTRO INTEGRAL DE SERVICIOS PSICOLOGICOS
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-0001
Mailing Address - Country:US
Mailing Address - Phone:787-934-5362
Mailing Address - Fax:
Practice Address - Street 1:4250 CARR #2
Practice Address - Street 2:CENTRO INTEGRAL DE SERVICIOS PSICOLOGICOS
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-0001
Practice Address - Country:US
Practice Address - Phone:787-934-5362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-30
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist