Provider Demographics
NPI:1538321641
Name:CABRERA, MILLYAN P (LMHC, RPT)
Entity Type:Individual
Prefix:
First Name:MILLYAN
Middle Name:P
Last Name:CABRERA
Suffix:
Gender:F
Credentials:LMHC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 CLEARCREEK DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-2000
Mailing Address - Country:US
Mailing Address - Phone:813-391-3610
Mailing Address - Fax:
Practice Address - Street 1:3202 HENDERSON BLVD
Practice Address - Street 2:SUITE 100A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3099
Practice Address - Country:US
Practice Address - Phone:813-391-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9209101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health