Provider Demographics
NPI:1871992263
Name:CABRERA, SUE E (SW)
Entity type:Individual
Prefix:MISS
First Name:SUE
Middle Name:E
Last Name:CABRERA
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AG-25 CALLE ESPIRITU SANTO
Mailing Address - Street 2:URB RIO HONDO II
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-901-8411
Mailing Address - Fax:
Practice Address - Street 1:AG25 ESPIRITU SANTO STREET
Practice Address - Street 2:RIO HONDO 2
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3228
Practice Address - Country:US
Practice Address - Phone:787-901-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR111351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical