Provider Demographics
NPI:1124441290
Name:COLON, MARIA DEL MAR
Entity type:Individual
Prefix:
First Name:MARIA DEL MAR
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 1:140 CARR 842 APT 2502
Mailing Address - Street 2:CARR. 842
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9758
Mailing Address - Country:US
Mailing Address - Phone:787-642-6432
Mailing Address - Fax:
Practice Address - Street 1:140 CARR 842 APT 2502
Practice Address - Street 2:CARR. 842
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9758
Practice Address - Country:US
Practice Address - Phone:787-642-6432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist