Provider Demographics
NPI:1023351665
Name:COLON, LIZBETH
Entity type:Individual
Prefix:MRS
First Name:LIZBETH
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 53118
Mailing Address - Street 2:SAN ANTONIO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-9208
Mailing Address - Country:US
Mailing Address - Phone:787-530-3682
Mailing Address - Fax:
Practice Address - Street 1:HC 5 BOX 53118
Practice Address - Street 2:SAN ANTONIO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-9208
Practice Address - Country:US
Practice Address - Phone:787-530-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17630104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker