Provider Demographics
NPI:1821204181
Name:COLON, ENID DEL C (MS)
Entity Type:Individual
Prefix:MISS
First Name:ENID
Middle Name:DEL C
Last Name:COLON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951-0580
Mailing Address - Country:US
Mailing Address - Phone:787-794-2798
Mailing Address - Fax:787-779-8196
Practice Address - Street 1:CARR #2 INTERIOR
Practice Address - Street 2:BO. CANDELARIA KM 19.9
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00951
Practice Address - Country:US
Practice Address - Phone:787-779-8196
Practice Address - Fax:787-779-8196
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR443235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist