Healthcare Provider Details

I. General information

NPI: 1033884861
Provider Name (Legal Business Name): TERESA MARIE ARRIAGA BCBA 1-25-79473
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERESA MARIE TREJO

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 LORAINE AVE S
LEHIGH ACRES FL
33976-3044
US

IV. Provider business mailing address

1604 LORAINE AVE S
LEHIGH ACRES FL
33976-3044
US

V. Phone/Fax

Practice location:
  • Phone: 954-665-9457
  • Fax: 239-424-8055
Mailing address:
  • Phone: 954-665-9457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12579473
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-156167
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: