Doctor Name: | GABRIEL E COLLAZO BURGOS |
NPI Number: | 1578967808 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | 4088 |
Business Practice Address: | 168 Ave Barbosa Catano, PR - 009624782 |
Business Phone Number: | 7877884544 |
Business Fax Number: | |
Mailing Address: | Po Box 162, CATANO |
State: | PR |
Postal Code: | 009630162 |
Phone Number: | 7877884544 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2014 |
NPI Last Update Date: | 10/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 4088 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |