Provider Demographics
NPI:1205273703
Name:BURDO, ARIELLE ROSE (PSYD)
Entity type:Individual
Prefix:MISS
First Name:ARIELLE
Middle Name:ROSE
Last Name:BURDO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8089 TUMBLESTONE CT
Mailing Address - Street 2:APT 623
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-4440
Mailing Address - Country:US
Mailing Address - Phone:954-993-1149
Mailing Address - Fax:
Practice Address - Street 1:5841 CORPORATE WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2039
Practice Address - Country:US
Practice Address - Phone:561-684-1991
Practice Address - Fax:561-684-8582
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9397103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent