Provider Demographics
NPI:1285476911
Name:CAVALARO, FERNANDA PEREIRA
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:PEREIRA
Last Name:CAVALARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FERNANDA
Other - Middle Name:
Other - Last Name:CAVALARO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FERNANDA CAVALARO
Mailing Address - Street 1:115 BROOKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-5764
Mailing Address - Country:US
Mailing Address - Phone:601-307-4308
Mailing Address - Fax:
Practice Address - Street 1:115 BROOKWOOD LN
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-5764
Practice Address - Country:US
Practice Address - Phone:601-307-4308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health