Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4250 | PR |
NPI | 1104258839 |
---|---|
Provider Name | Mrs. Glorimar Colon |
First Address | Caguas, PUERTO RICO 00726 |
Second Address | Caguas, PR 00727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2013 |
Last Update Date | 10/09/2015 |