Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003297474 |
---|---|
Provider Name | Tianna-Mari Cabrera |
First Address | Bronx, NY 10455-3901 |
Second Address | Bronx, NY 10455-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2015 |
Last Update Date | 11/06/2015 |