Provider Demographics
NPI:1619715620
Name:CABRERA RIVERA, LESLIE (RBT)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:CABRERA RIVERA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18412 HOMESTEAD AVE APT 229
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6854
Mailing Address - Country:US
Mailing Address - Phone:786-657-8580
Mailing Address - Fax:
Practice Address - Street 1:18412 HOMESTEAD AVE APT 229
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-6854
Practice Address - Country:US
Practice Address - Phone:786-657-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1146880106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician