Provider Demographics
NPI:1942532049
Name:COLON, URSULA M
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:M
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 1:867 AVE MUNOZ RIVERA
Mailing Address - Street 2:VICK CENTER 867 MUNOZ RIVERA AVE OFIC D206
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2102
Mailing Address - Country:US
Mailing Address - Phone:787-998-8441
Mailing Address - Fax:
Practice Address - Street 1:867 AVE MUNOZ RIVERA
Practice Address - Street 2:VICK CENTER 867 MUNOZ RIVERA AVE OFIC D206
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-2102
Practice Address - Country:US
Practice Address - Phone:787-998-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001648103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling