Provider Demographics
NPI:1598161614
Name:CABULONG, RAMONCITO
Entity Type:Individual
Prefix:
First Name:RAMONCITO
Middle Name:
Last Name:CABULONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3742 KELTIE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3233
Mailing Address - Country:US
Mailing Address - Phone:702-340-5070
Mailing Address - Fax:702-684-7788
Practice Address - Street 1:3742 KELTIE BROOK DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3233
Practice Address - Country:US
Practice Address - Phone:702-340-5070
Practice Address - Fax:702-684-7788
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor