Provider Demographics
NPI:1942022066
Name:DELACRUZ, PAOLA
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:DELACRUZ
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 1:44125 WOODRIDGE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-443-4890
Mailing Address - Fax:
Practice Address - Street 1:44125 WOODRIDGE PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-443-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician