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General NPI Number Information
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NPI Number | 1235516295
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Entity Type | Individual
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Provider Name | RACQUEL CABRERA ATC, OTC
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Gender | Female
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1968 HAWKS LN NE
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City | BROOKHAVEN
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State | GA
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Zip | 30329-2283
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Country | US
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Telephone | 404-778-7137
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Fax |
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Provider Business Mailing Address
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Address Line | 1968 HAWKS LN NE
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City | BROOKHAVEN
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State | GA
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Zip | 30329-2283
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Country | US
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Telephone | 404-778-7137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096.004600
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126002295
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 36002187A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT004644
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License Number State | GA
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