Provider Demographics
NPI:1477976793
Name:CABEZAS VILASECO, ANAIS
Entity Type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:CABEZAS VILASECO
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 1:26362 SW 139TH PL
Mailing Address - Street 2:
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6606
Mailing Address - Country:US
Mailing Address - Phone:786-417-9359
Mailing Address - Fax:
Practice Address - Street 1:26362 SW 139TH PL
Practice Address - Street 2:
Practice Address - City:NARANJA
Practice Address - State:FL
Practice Address - Zip Code:33032-6606
Practice Address - Country:US
Practice Address - Phone:786-417-9359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst