Provider Demographics
NPI:1841651759
Name:CUBARA, INNA
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:CUBARA
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 1:213 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-3301
Mailing Address - Country:US
Mailing Address - Phone:267-466-9584
Mailing Address - Fax:
Practice Address - Street 1:213 CHURCH RD
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-3301
Practice Address - Country:US
Practice Address - Phone:267-466-9584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-19
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor