Basic Information
| Provider Information | |||||||||
| NPI: | 1346531035 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CABADA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | OLGA | ||||||||
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| Credential: | LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 PERKINS DR STE B | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880053248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755266682 | ||||||||
| FaxNumber: | 5756473777 | ||||||||
| Practice Location | |||||||||
| Address1: | 1080 MED PARK DR | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880053226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5756473773 | ||||||||
| FaxNumber: | 5756473777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2011 | ||||||||
| LastUpdateDate: | 04/28/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I-07316 | NM | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.