Provider Demographics
NPI:1376261156
Name:ARRIERA, STEFANIE TANIA (BCBA)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:TANIA
Last Name:ARRIERA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 NE 181ST ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1623
Mailing Address - Country:US
Mailing Address - Phone:850-264-4794
Mailing Address - Fax:
Practice Address - Street 1:12039 SW 132ND CT UNIT 33
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4786
Practice Address - Country:US
Practice Address - Phone:786-899-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BCBA1-23-66551103K00000X
RBT-22-225854106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115324900Medicaid