Provider Demographics
NPI:1578175188
Name:ACOSTA, ARIANNA (RBT-20-129936)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:RBT-20-129936
Other - Prefix:
Other - First Name:ARIANNA
Other - Middle Name:
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT-20-129936
Mailing Address - Street 1:4844 NW 113TH PL
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4850
Mailing Address - Country:US
Mailing Address - Phone:786-606-7515
Mailing Address - Fax:
Practice Address - Street 1:4844 NW 113TH PL
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4850
Practice Address - Country:US
Practice Address - Phone:786-606-7515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-129936106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108550900Medicaid