Healthcare Provider Details

I. General information

NPI: 1003752205
Provider Name (Legal Business Name): ARIADNA LEYVA CRUZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 CAPITAL CT
MANASSAS VA
20110-2044
US

IV. Provider business mailing address

1002B MAYS LN
MANASSAS PARK VA
20111-7251
US

V. Phone/Fax

Practice location:
  • Phone: 703-770-8060
  • Fax:
Mailing address:
  • Phone: 786-943-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-471343
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: