Provider Demographics
NPI:1598091126
Name:CABRERA, FIANNY SOLEDAD (SLP)
Entity Type:Individual
Prefix:
First Name:FIANNY
Middle Name:SOLEDAD
Last Name:CABRERA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 W 178TH ST APT 54
Mailing Address - Street 2:1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6540
Mailing Address - Country:US
Mailing Address - Phone:917-981-7894
Mailing Address - Fax:
Practice Address - Street 1:592 W 178TH ST APT 54
Practice Address - Street 2:1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6540
Practice Address - Country:US
Practice Address - Phone:917-981-7894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist