Provider Demographics
NPI:1730637687
Name:MABREY, WILLIAM JR
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:MABREY
Suffix:JR
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 1:201 THORNBERRY BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-3652
Mailing Address - Country:US
Mailing Address - Phone:513-332-8253
Mailing Address - Fax:
Practice Address - Street 1:1042 THUNDERBIRD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5824
Practice Address - Country:US
Practice Address - Phone:513-332-8253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist