Provider Demographics
NPI:1326459686
Name:CUBAS, ROSAURA
Entity Type:Individual
Prefix:
First Name:ROSAURA
Middle Name:
Last Name:CUBAS
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 1:1317 BUTTERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0663
Mailing Address - Country:US
Mailing Address - Phone:254-220-1148
Mailing Address - Fax:
Practice Address - Street 1:1317 BUTTERWOOD CIR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0663
Practice Address - Country:US
Practice Address - Phone:254-220-1148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC010362104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker