=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003752205
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARIADNA LEYVA CRUZ RBT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2026
-----------------------------------------------------
Last Update Date | 04/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9720 CAPITAL CT
-----------------------------------------------------
City | MANASSAS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20110-2044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-770-8060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1002B MAYS LN
-----------------------------------------------------
City | MANASSAS PARK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20111-7251
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-943-3337
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT-25-471343
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------