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General NPI Number Information
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NPI Number | 1285355024
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Entity Type | Individual
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Provider Name | MIRELYS MARIE PEREZ COLON
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Gender | Female
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | BO CAONILLAS ABAJO, SECT. CERRO GORDO CARR. 150 INT. 5520
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City | VILLALBA
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State | PR
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Zip | 00766
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Country | US
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Telephone | 787-527-9087
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Fax |
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Provider Business Mailing Address
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Address Line | HC 3 BOX 9106
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City | VILLALBA
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State | PR
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Zip | 00766-9004
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Country | US
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Telephone | 787-527-9087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 7045
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License Number State | PR
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