Provider Demographics
NPI:1659150381
Name:CABRAL, INEZ MAE (DPT)
Entity Type:Individual
Prefix:
First Name:INEZ
Middle Name:MAE
Last Name:CABRAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20745 ROYAL PALACE SQ UNIT 420
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-8406
Mailing Address - Country:US
Mailing Address - Phone:703-401-3528
Mailing Address - Fax:
Practice Address - Street 1:19775 BELMONT EXECUTIVE PLZ STE 125
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7606
Practice Address - Country:US
Practice Address - Phone:571-498-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist