Provider Demographics
NPI:1114684107
Name:CABRERO, NATALIA
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:CABRERO
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 1:3809 LAKE EASTBROOK BLVD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-5931
Mailing Address - Country:US
Mailing Address - Phone:616-604-8492
Mailing Address - Fax:
Practice Address - Street 1:3809 LAKE EASTBROOK BLVD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5931
Practice Address - Country:US
Practice Address - Phone:616-604-8492
Practice Address - Fax:616-604-8492
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant