Provider Demographics
NPI:1922351428
Name:COLBERG-PEREZ, NANCY A
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:A
Last Name:COLBERG-PEREZ
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 1:830 CALLE ASOMANTE
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6231
Mailing Address - Country:US
Mailing Address - Phone:787-833-5938
Mailing Address - Fax:
Practice Address - Street 1:830 CALLE ASOMANTE
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6231
Practice Address - Country:US
Practice Address - Phone:787-833-5938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR35821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical