Provider Demographics
NPI:1821671827
Name:CABRERA, MADELINE CHRISTINE
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:CHRISTINE
Last Name:CABRERA
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 1:2617 27TH ST W
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-0509
Mailing Address - Country:US
Mailing Address - Phone:239-980-1502
Mailing Address - Fax:
Practice Address - Street 1:2617 27TH ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-0509
Practice Address - Country:US
Practice Address - Phone:239-980-1502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician