Provider Demographics
NPI:1205366341
Name:COLON TORRES, NILDA R (PHD)
Entity Type:Individual
Prefix:
First Name:NILDA
Middle Name:R
Last Name:COLON TORRES
Suffix:
Gender:F
Credentials:PHD
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 225
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0225
Mailing Address - Country:US
Mailing Address - Phone:787-202-8464
Mailing Address - Fax:
Practice Address - Street 1:156 CALLE BARCELO # 53
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1621
Practice Address - Country:US
Practice Address - Phone:787-857-2688
Practice Address - Fax:787-857-1730
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3207103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical