Provider Demographics
NPI:1891568333
Name:COLON BOU, ELIXANDRA
Entity type:Individual
Prefix:
First Name:ELIXANDRA
Middle Name:
Last Name:COLON BOU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HARTWELL AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-3100
Mailing Address - Country:US
Mailing Address - Phone:781-861-0890
Mailing Address - Fax:
Practice Address - Street 1:URB. QUINTAS DE MOROVIS
Practice Address - Street 2:B3 CALLE 3
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687
Practice Address - Country:US
Practice Address - Phone:612-383-7584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health