Provider Demographics
NPI:1841853066
Name:BLASINI, MELISSA (MSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BLASINI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB ESTANCIAS DE MOUNTAIN VIEW
Mailing Address - Street 2:83 CALLE DONA JUANA
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-313-6094
Mailing Address - Fax:
Practice Address - Street 1:109 AVE PEDRO ALBIZU SANTOS LA FUENTE TOWN CENTER
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-0078
Practice Address - Country:US
Practice Address - Phone:787-296-9777
Practice Address - Fax:787-296-9712
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR229101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical