Provider Demographics
NPI:1780825026
Name:MELENDEZ, SONIA (PHD)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 CARR 848 APT 286
Mailing Address - Street 2:COND. PLAZA DEL PARQUE
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3017
Mailing Address - Country:US
Mailing Address - Phone:787-283-3031
Mailing Address - Fax:787-283-3031
Practice Address - Street 1:65 CARR 848 APT 286
Practice Address - Street 2:COND. PLAZA DEL PARQUE
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3017
Practice Address - Country:US
Practice Address - Phone:787-283-3031
Practice Address - Fax:787-283-3031
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1915103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool