Provider Demographics
NPI:1316181191
Name:COLON, YARI L (PHD)
Entity Type:Individual
Prefix:DR
First Name:YARI
Middle Name:L
Last Name:COLON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:YARI
Other - Middle Name:L
Other - Last Name:COLON-TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:200 AVE LOS CHALETS
Mailing Address - Street 2:BOX 47 CHALETS DE CUPEY
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4460
Mailing Address - Country:US
Mailing Address - Phone:787-467-1041
Mailing Address - Fax:787-641-5881
Practice Address - Street 1:200 AVE LOS CHALETS
Practice Address - Street 2:BOX 47 CHALETS DE CUPEY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4460
Practice Address - Country:US
Practice Address - Phone:787-467-1041
Practice Address - Fax:787-641-5881
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3208103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3208OtherPROFESSIONAL LICENSE