Provider Demographics
NPI:1780304451
Name:COLON, GLORIBEL (CPL)
Entity type:Individual
Prefix:
First Name:GLORIBEL
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:CPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VALLE ESCONDIDO
Mailing Address - Street 2:CALLE PALMA REAL 193
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-216-0002
Mailing Address - Fax:
Practice Address - Street 1:URB. VALLE ESCONDIDO
Practice Address - Street 2:CALLE PALMA REAL 193
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-216-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4221101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor