Provider Demographics
NPI:1265001564
Name:CABRERA, STEPHANIE (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10767 100TH ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-2634
Mailing Address - Country:US
Mailing Address - Phone:347-543-4045
Mailing Address - Fax:
Practice Address - Street 1:10767 100TH ST
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-2634
Practice Address - Country:US
Practice Address - Phone:347-543-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool