Provider Demographics
NPI:1366146847
Name:CABRERA, AURA B (RPT)
Entity type:Individual
Prefix:
First Name:AURA
Middle Name:B
Last Name:CABRERA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:AURA
Other - Middle Name:D
Other - Last Name:BUNDOC-CABRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:1532 WESTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3045
Mailing Address - Country:US
Mailing Address - Phone:248-346-5763
Mailing Address - Fax:
Practice Address - Street 1:35450 DEQUINDRE RD STE 104
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4810
Practice Address - Country:US
Practice Address - Phone:866-335-3255
Practice Address - Fax:586-601-2500
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist