Provider Demographics
NPI:1730940925
Name:HIDALGO CABRERA, CORAIMA ELIZABETH
Entity type:Individual
Prefix:MS
First Name:CORAIMA
Middle Name:ELIZABETH
Last Name:HIDALGO CABRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LOWELL TER
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-4650
Mailing Address - Country:US
Mailing Address - Phone:508-801-4585
Mailing Address - Fax:
Practice Address - Street 1:9 LOWELL TER
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-4650
Practice Address - Country:US
Practice Address - Phone:508-801-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician