Organization
INTERCEDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS IVONNE COLON (DIRECTORA)
(939) 238-1864
Entity
Organization
Contact information
Practice address
239 SABANETAS IND PK, PONCE, PR 00716-4401
(939) 238-1864
Mailing address
239 SABANETAS IND PK, ACADEMIA PONCE INTER API, 2DO NIVEL, PONCE, PR 00716-4401
(939) 238-1864
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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