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General NPI Number Information
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NPI Number | 1265295182
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Entity Type | Individual
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Provider Name | EMMA BERENICE CABREA
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Gender | Female
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 121 INTERPARK BLVD STE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78216-1844
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Country | US
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Telephone | 888-764-9452
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Fax |
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Provider Business Mailing Address
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Address Line | 106 LEWIS ST APT 229
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City | SAN ANTONIO
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State | TX
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Zip | 78212-5503
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Country | US
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Telephone | 475-309-8105
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | BACB897028
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License Number State | CT
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