Individual
EVELYN CABRAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
62 HAWTHORNE ST, SELDEN, NY 11784-1336
(631) 830-1472
Mailing address
62 HAWTHORNE ST, SELDEN, NY 11784-1336
(631) 830-1472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12134
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12134
CASAC
NY
Enumeration date
02/13/2014
Last updated
02/13/2014
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