Provider Demographics
NPI:1609115203
Name:CABAN, ELIZABETH ARLEEN (LCDA)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ARLEEN
Last Name:CABAN
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ARLEEN
Other - Last Name:CABAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:552 AVE JOSE A CEDENO
Mailing Address - Street 2:ARECIBO MINI PLAZA SUITE 4
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3963
Mailing Address - Country:US
Mailing Address - Phone:787-479-2229
Mailing Address - Fax:787-915-5590
Practice Address - Street 1:552 AVE JOSE A CEDENO
Practice Address - Street 2:ARECIBO MINI PLAZA SUITE 4
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3963
Practice Address - Country:US
Practice Address - Phone:787-479-2229
Practice Address - Fax:787-915-5590
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3193103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist