Provider Demographics
NPI:1639785736
Name:CEBOLLERO, AUBRI ANN
Entity Type:Individual
Prefix:
First Name:AUBRI
Middle Name:ANN
Last Name:CEBOLLERO
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 1:1582 W 500 S
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-7188
Mailing Address - Country:US
Mailing Address - Phone:801-678-6429
Mailing Address - Fax:
Practice Address - Street 1:1525 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-5638
Practice Address - Country:US
Practice Address - Phone:801-621-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical