MEDICARE: ASHLEY MARIE CRUZ BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	2021046242	MO
2	106S00000X	Behavior Technician	RBT-18-68220	MO
3	103K00000X	Behavior Analyst	LBA00501	KS

General Provider Information

NPI Number	:	1720554421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MARIE CRUZ BCBA

Provider Business Mailing Address
First Line	:	6217 N 25TH STREET TER
Second Line	:
City	:	COUNTRY CLUB
State	:	MO
Zip	:	64505-1006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7280 NW 87TH TERRACE
Second Line	:	SUITE C-210
City	:	KANSAS CITY
State	:	MO
Zip	:	64153-3720
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2018
Last Update Date	:	02/04/2026

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