Provider Demographics
NPI:1376164889
Name:COLON-GONZALEZ, KATHIA J (MSW)
Entity Type:Individual
Prefix:
First Name:KATHIA
Middle Name:J
Last Name:COLON-GONZALEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB MEDINA CALLE 7
Mailing Address - Street 2:E33
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-7058
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB MEDINA CALLE 7
Practice Address - Street 2:E33
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-7058
Practice Address - Country:US
Practice Address - Phone:787-314-1851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR150141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical