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General NPI Number Information
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NPI Number | 1497210926
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Entity Type | Individual
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Provider Name | YVETTE COLON MSW, PHD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | 124 PEARL ST STE 503
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City | YPSILANTI
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State | MI
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Zip | 48197-2663
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Country | US
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Telephone | 734-985-0265
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Fax | 888-965-5133
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Provider Business Mailing Address
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Address Line | 6321 OAKBROOK DR
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City | YPSILANTI
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State | MI
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Zip | 48197-9493
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Country | US
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Telephone | 734-961-7113
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Fax | 888-965-5133
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801089888
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License Number State | MI
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