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General NPI Number Information
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NPI Number | 1558801266
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Entity Type | Individual
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Provider Name | MARIA DE LOURDES NADAL COLON PSY. D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 23 CALLE ALFONSO XII 40 AVE PADRE NOEL
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City | PONCE
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State | PR
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Zip | 00716-8034
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Country | US
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Telephone | 787-259-4463
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Fax |
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Provider Business Mailing Address
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Address Line | A14 CALLE PALMA REAL URB. SAGRADO CORAZON
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City | PONCE
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State | PR
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Zip | 00716-2548
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Country | US
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Telephone | 787-675-2261
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5839
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License Number State | PR
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