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Individual

MR. JESUS MANUEL VEGA-CABRERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC-T

Contact information

Practice address
3 COTTAGE PL, NEW ROCHELLE, NY 10801-4201
(914) 235-6633
Mailing address
1920 WASHINGTON AVE APT 209, BRONX, NY 10457-4307
(917) 645-8073

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37998
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7851
NY
Enumeration date
07/26/2022
Last updated
07/26/2022
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