Provider Demographics
NPI:1578799839
Name:RODRIGUEZ-COLON, AMARILYS (MA)
Entity Type:Individual
Prefix:MISS
First Name:AMARILYS
Middle Name:
Last Name:RODRIGUEZ-COLON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 AVE ANTONIO RIVERA
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-1700
Mailing Address - Country:US
Mailing Address - Phone:787-647-1266
Mailing Address - Fax:
Practice Address - Street 1:R5 AVE CUPEY GDNS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7333
Practice Address - Country:US
Practice Address - Phone:787-647-1266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3296103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling