MEDICARE: SARA CABELLO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	9351	TX

General Provider Information

NPI Number	:	1285868794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA CABELLO LPC

Provider Business Mailing Address
First Line	:	PO BOX 2127
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77410-2127
Country	:	US
Telephone Number	:	281-477-6363
Fax Number	:	281-477-6356

Provider Business Practice Location Address
First Line	:	6423 MCPHERSON RD
Second Line	:	SUITE# 9
City	:	LAREDO
State	:	TX
Zip	:	78041-6179
Country	:	US
Telephone Number	:	281-477-6363
Fax Number	:	281-477-6356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2009
Last Update Date	:	05/12/2009

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