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Individual

L EMILY BROWN CABEZUDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
626 N. RIDGE STREET, STE C, DANVILLE, VA 24541-5652
(434) 334-7143
(480) 557-5712
Mailing address
801 MILL RD, GOLDSBORO, NC 27534-8947
(336) 707-5871
(919) 988-1042

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3576
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3648958
AETNA PROVIDER NUMBER
AZ
01
700885000
MAGELLAN
AZ
01
AZ 0618080
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
08/17/2005
Last updated
02/23/2017
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