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General NPI Number Information
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NPI Number | 1760714836
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Entity Type | Individual
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Provider Name | LIBNA A. SANJURJO-MELENDEZ PSYD.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | EA-4 CALLE ROSA DE TEJAS URB. LA ROSALEDA
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City | LEVITTOWN
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-587-4130
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 7171
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City | SAN JUAN
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State | PR
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Zip | 00916
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Country | US
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Telephone | 787-587-4130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3678
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License Number State | PR
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