Provider Demographics
NPI:1689729428
Name:MUNIZ, MAIREEN (MSPHL)
Entity type:Individual
Prefix:
First Name:MAIREEN
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:MSPHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#138 CALLE MIGUEL RIVERA TEXIDOR
Mailing Address - Street 2:ESTANCIAS DEL GOLF CLUB
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-0545
Mailing Address - Country:US
Mailing Address - Phone:787-259-3602
Mailing Address - Fax:
Practice Address - Street 1:#1731 PASEO LAS COLONIAS
Practice Address - Street 2:URB. COSNTANCIA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2237
Practice Address - Country:US
Practice Address - Phone:787-647-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist