Provider Demographics
NPI:1871802637
Name:MELENDEZ, NANCY I (MPSYC)
Entity type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:I
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MPSYC
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 34
Mailing Address - Street 2:
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782-0034
Mailing Address - Country:US
Mailing Address - Phone:787-359-0091
Mailing Address - Fax:
Practice Address - Street 1:BO. VEGA REDONDA STREET 7774 KM 3.0
Practice Address - Street 2:
Practice Address - City:COMERIO
Practice Address - State:PR
Practice Address - Zip Code:00782
Practice Address - Country:US
Practice Address - Phone:787-359-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3782103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling