Provider Demographics
NPI:1043078884
Name:CABRAL, SAVANNAH MARIE
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MARIE
Last Name:CABRAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 MARION RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-1406
Mailing Address - Country:US
Mailing Address - Phone:774-454-1994
Mailing Address - Fax:508-273-2353
Practice Address - Street 1:31 HILLER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02770-4024
Practice Address - Country:US
Practice Address - Phone:774-454-1994
Practice Address - Fax:508-273-2353
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician