Provider Demographics
NPI:1942814967
Name:CABRERA-SANTANA, YADISLEY (RBT)
Entity Type:Individual
Prefix:
First Name:YADISLEY
Middle Name:
Last Name:CABRERA-SANTANA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 NE 4TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5011
Mailing Address - Country:US
Mailing Address - Phone:786-863-0216
Mailing Address - Fax:
Practice Address - Street 1:620 NE 4TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5011
Practice Address - Country:US
Practice Address - Phone:786-863-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB542484106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician