Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2240 | PR |
NPI | 1093849028 |
---|---|
Provider Name | Mrs. Maria Magdalena Colton |
First Address | Toa Baja, PR 00949-4919 |
Second Address | Toa Baja, PR 00949-5388 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |