Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | CA | |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1235649997 |
---|---|
Provider Name | Marie Kimberly Cabrera |
First Address | El Centro, CA 92243-2302 |
Second Address | El Centro, CA 92243-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2017 |
Last Update Date | 31/01/2022 |