Provider Demographics
NPI:1881304046
Name:ESPINOSA, MELENIE A (LICENSE PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:MELENIE
Middle Name:A
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:LICENSE PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:PUNTA SANTIAGO
Mailing Address - State:PR
Mailing Address - Zip Code:00741-0526
Mailing Address - Country:US
Mailing Address - Phone:787-672-0101
Mailing Address - Fax:
Practice Address - Street 1:URB. PASEOS DE LOS ARTESANOS CALLE RAFAELA RIVERA
Practice Address - Street 2:#46
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-0077
Practice Address - Country:US
Practice Address - Phone:787-672-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7154103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling