Provider Demographics
NPI:1659577419
Name:COLON, YALESKA
Entity Type:Individual
Prefix:
First Name:YALESKA
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BD14 CALLE RIO ORINOCO
Mailing Address - Street 2:URB. VALLE VERDE 2
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3268
Mailing Address - Country:US
Mailing Address - Phone:787-454-6496
Mailing Address - Fax:787-993-1790
Practice Address - Street 1:BD14 CALLE RIO ORINOCO
Practice Address - Street 2:URB. VALLE VERDE 2
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3268
Practice Address - Country:US
Practice Address - Phone:787-454-6496
Practice Address - Fax:787-993-1790
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2239103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling