Provider Demographics
NPI:1457084683
Name:TURELL COLLAZO, MABEL
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:TURELL COLLAZO
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:ALTAVISTA 1832 CALLE CLAVEL
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2933
Mailing Address - Country:US
Mailing Address - Phone:787-677-4143
Mailing Address - Fax:
Practice Address - Street 1:22 CALLE SOL STE 1
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3820
Practice Address - Country:US
Practice Address - Phone:787-677-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty