Provider Demographics
NPI:1427596014
Name:COLON, MARILIN (PHD, BCBA-D)
Entity Type:Individual
Prefix:
First Name:MARILIN
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6804 SUNSHADE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75236-0104
Mailing Address - Country:US
Mailing Address - Phone:925-667-6141
Mailing Address - Fax:
Practice Address - Street 1:6804 SUNSHADE LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75236-0104
Practice Address - Country:US
Practice Address - Phone:925-667-6141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst