Provider Demographics
NPI:1215619655
Name:HERNANDEZ, MELANIE JOHANIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:JOHANIE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO PRIMAVERA
Mailing Address - Street 2:APT 1831
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960
Mailing Address - Country:US
Mailing Address - Phone:787-231-9763
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSIDAD CARLOS ALBIZU
Practice Address - Street 2:151 CALLE DE LA TANCA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-0090
Practice Address - Country:US
Practice Address - Phone:787-945-2776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7175103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical