Provider Demographics
NPI:1447959457
Name:COLON, DYAN MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:DYAN
Middle Name:MARIE
Last Name:COLON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2400 SUITE 182
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705
Mailing Address - Country:US
Mailing Address - Phone:787-429-0315
Mailing Address - Fax:
Practice Address - Street 1:CALLE CAOBA A2
Practice Address - Street 2:ESTANCIAS DE ASOMANTE
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-0070
Practice Address - Country:US
Practice Address - Phone:787-429-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR147141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical