Provider Demographics
NPI:1336423045
Name:COLON, SANDRA E (OTR)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:COLON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CALLE CORAL
Mailing Address - Street 2:APT 321
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3047
Mailing Address - Country:US
Mailing Address - Phone:787-431-1288
Mailing Address - Fax:
Practice Address - Street 1:3000 CALLE CORAL
Practice Address - Street 2:APT 321
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3047
Practice Address - Country:US
Practice Address - Phone:787-431-1288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR765225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist