Provider Demographics
NPI:1164251674
Name:AGUILERA CRESPO, ARIARMY
Entity type:Individual
Prefix:
First Name:ARIARMY
Middle Name:
Last Name:AGUILERA CRESPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 EVERGREEN LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-4038
Mailing Address - Country:US
Mailing Address - Phone:786-224-8123
Mailing Address - Fax:
Practice Address - Street 1:224 EVERGREEN LN
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-4038
Practice Address - Country:US
Practice Address - Phone:786-224-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-359921106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician