Provider Demographics
NPI:1194521708
Name:CLAVIJO COLON, PAOLA NICOLE (CRL, CRC)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:NICOLE
Last Name:CLAVIJO COLON
Suffix:
Gender:
Credentials:CRL, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A28 VILLAS DEL BOSQUE
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-9202
Mailing Address - Country:US
Mailing Address - Phone:787-556-2376
Mailing Address - Fax:
Practice Address - Street 1:ST. NO. 2 KM 8.2 BO. JUAN SANCHEZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960-7087
Practice Address - Country:US
Practice Address - Phone:787-763-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1806225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor