Doctor Name: | MRS. MIRTA LILIAN CABRERA |
NPI Number: | 1043588619 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | TLPC |
License Number: | 870-226 |
Business Practice Address: | 16100 W Greenfield Ave Brookfield, WI - 530056906 |
Business Phone Number: | 9208897200 |
Business Fax Number: | |
Mailing Address: | 16100 W Greenfield Ave, BROOKFIELD |
State: | WI |
Postal Code: | 53005 |
Phone Number: | 9208897200 |
Fax Number: | |
NPI Enumeration Date: | 12/09/2011 |
NPI Last Update Date: | 12/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 870-226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |