Provider Demographics
NPI:1265990105
Name:COLOMBA, MELANY (SOCIAL WORKER)
Entity type:Individual
Prefix:MRS
First Name:MELANY
Middle Name:
Last Name:COLOMBA
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:MRS
Other - First Name:MELANY
Other - Middle Name:
Other - Last Name:COLOMBA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SOCIAL WORK
Mailing Address - Street 1:CIUDAD UNIVERSITARIA A
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-557-1413
Mailing Address - Fax:
Practice Address - Street 1:CALLE VOLGA
Practice Address - Street 2:CIUDAD UNIVERSITARIA
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-557-1413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR115521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22OtherPROVIDER