| Doctor Name: | MS. ILEANA CRUZ COLON |
| NPI Number: | 1164752614 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 16670 |
| Business Practice Address: | Carr Estatal 14 Int Calle Sargento Gerardo Santiago Aibonito, PR - 00705 |
| Business Phone Number: | 7877142462 |
| Business Fax Number: | 7877353749 |
| Mailing Address: | Po Box 1379, AIBONITO |
| State: | PR |
| Postal Code: | 007051379 |
| Phone Number: | 7877142462 |
| Fax Number: | 7877353749 |
| NPI Enumeration Date: | 01/06/2010 |
| NPI Last Update Date: | 01/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 16670 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |