Provider Demographics
NPI:1518748235
Name:DELA CRUZ, PRESLEY IRWIN (ABA)
Entity Type:Individual
Prefix:
First Name:PRESLEY
Middle Name:IRWIN
Last Name:DELA CRUZ
Suffix:
Gender:M
Credentials:ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-2910
Mailing Address - Country:US
Mailing Address - Phone:339-235-9056
Mailing Address - Fax:
Practice Address - Street 1:73 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-2910
Practice Address - Country:US
Practice Address - Phone:339-235-9056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst