Provider Demographics
NPI:1235849035
Name:PACHECO CABRERA, DENISE XIOMARA (MSW, ISW,FDC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:XIOMARA
Last Name:PACHECO CABRERA
Suffix:
Gender:F
Credentials:MSW, ISW,FDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 25TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-3739
Mailing Address - Country:US
Mailing Address - Phone:813-734-4288
Mailing Address - Fax:
Practice Address - Street 1:623 25TH AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-3739
Practice Address - Country:US
Practice Address - Phone:813-734-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15347104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker