Provider Demographics
NPI:1770871964
Name:COLON MELENDEZ, YARITZA M (PHD)
Entity type:Individual
Prefix:DR
First Name:YARITZA
Middle Name:M
Last Name:COLON MELENDEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PORTALES DE ALHELI 2050
Mailing Address - Street 2:CARR 8177 APTO 601
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:939-644-0344
Mailing Address - Fax:
Practice Address - Street 1:608A AVE ESCORIAL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4719
Practice Address - Country:US
Practice Address - Phone:939-644-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3994103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical