Provider Demographics
NPI:1669051017
Name:DE LA CRUZ, ARIELLE
Entity type:Individual
Prefix:MRS
First Name:ARIELLE
Middle Name:
Last Name:DE LA CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:
Other - Last Name:HOLLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3661 CORTEZ RD W STE 350
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3234
Mailing Address - Country:US
Mailing Address - Phone:941-405-0611
Mailing Address - Fax:
Practice Address - Street 1:3661 CORTEZ RD W STE 350
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3234
Practice Address - Country:US
Practice Address - Phone:941-405-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X, 106S00000X
FL1-25-80566103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician