Provider Demographics
NPI:1780798256
Name:COLON, ADA ELSIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ADA
Middle Name:ELSIE
Last Name:COLON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CALLE MATILDE REYES DE DA
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-2348
Mailing Address - Country:US
Mailing Address - Phone:787-803-2311
Mailing Address - Fax:787-803-2311
Practice Address - Street 1:3 CALLE MATILDE REYES DE DA
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-2348
Practice Address - Country:US
Practice Address - Phone:787-803-2311
Practice Address - Fax:787-803-2311
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2324103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical