Provider Demographics
NPI:1255888681
Name:COLON, AIXA MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:AIXA
Middle Name:MARIE
Last Name:COLON
Suffix:
Gender:F
Credentials:PHD
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 518
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-0518
Mailing Address - Country:US
Mailing Address - Phone:787-862-3000
Mailing Address - Fax:
Practice Address - Street 1:MOROVIS COMMUNITY HEALTH CENTER
Practice Address - Street 2:CALLE PATRON # 2
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687
Practice Address - Country:US
Practice Address - Phone:787-862-3000
Practice Address - Fax:787-862-2731
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5655103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical