Provider Demographics
NPI:1902497084
Name:CABRERA GUTIERREZ, MELANIE (RBT)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:
Last Name:CABRERA GUTIERREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:CABRERA GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:13719 SW 169TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6495
Mailing Address - Country:US
Mailing Address - Phone:786-367-8357
Mailing Address - Fax:
Practice Address - Street 1:13719 SW 169TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6495
Practice Address - Country:US
Practice Address - Phone:786-367-8357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-135273106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician