Individual
JOSE LUIS COLLAZO HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
Q13 CALLE JUAN P VARGAS, PONCE, PR 00728-6786
(939) 865-9631
Mailing address
Q13 CALLE JUAN P VARGAS, PONCE, PR 00728-6786
(939) 865-9631
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
15660
PR
1041C0700X
Clinical Social Worker
Primary
15660
PR
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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