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General NPI Number Information
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NPI Number | 1528207396
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Entity Type | Individual
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Provider Name | ISABELLE KALLIS COLON PH.D
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Gender | Female
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 1600 AVE PONCE DE LEON 1ST FLOOR
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City | SANTURCE
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State | PR
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Zip | 00909-1844
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Country | US
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Telephone | 787-724-9797
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Fax | 787-724-9700
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Provider Business Mailing Address
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Address Line | 1600 AVE PONCE DE LEON 1ST FLOOR
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City | SANTURCE
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State | PR
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Zip | 00909-1844
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Country | US
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Telephone | 787-724-9797
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Fax | 787-724-9700
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3244
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 3244
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3244
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License Number State | PR
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