Provider Demographics
NPI:1114657145
Name:APONTE COLON, NATALY
Entity Type:Individual
Prefix:
First Name:NATALY
Middle Name:
Last Name:APONTE COLON
Suffix:
Gender:F
Credentials:
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 1896
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-1896
Mailing Address - Country:US
Mailing Address - Phone:787-422-6193
Mailing Address - Fax:
Practice Address - Street 1:10445 SW CANYON RD STE 119B
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1938
Practice Address - Country:US
Practice Address - Phone:787-422-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4152101YP2500X
PR7315103TC0700X
ORC6860101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical