Provider Demographics
NPI:1790528255
Name:MILAN CABALE, MARISLEYSIS
Entity type:Individual
Prefix:
First Name:MARISLEYSIS
Middle Name:
Last Name:MILAN CABALE
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 1:452 E 31ST ST APT 114
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3392
Mailing Address - Country:US
Mailing Address - Phone:786-737-8688
Mailing Address - Fax:
Practice Address - Street 1:452 E 31ST ST APT 114
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3392
Practice Address - Country:US
Practice Address - Phone:786-737-8688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty