Provider Demographics
NPI:1205602240
Name:COLON, JENNIFER M I
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:M
Last Name:COLON
Suffix:I
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:HC 71 BOX 4411
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9586
Mailing Address - Country:US
Mailing Address - Phone:719-337-3187
Mailing Address - Fax:
Practice Address - Street 1:HC 71 4411
Practice Address - Street 2:URB HACIENDA LAS MERCEDES
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-9586
Practice Address - Country:US
Practice Address - Phone:719-337-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR127651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical