Provider Demographics
NPI:1841732286
Name:URGELLES ARIAS, DANAISA (BCBA)
Entity type:Individual
Prefix:
First Name:DANAISA
Middle Name:
Last Name:URGELLES ARIAS
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 1:106 BOXWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2005
Mailing Address - Country:US
Mailing Address - Phone:305-763-9079
Mailing Address - Fax:305-901-1797
Practice Address - Street 1:106 BOXWOOD CT
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-2005
Practice Address - Country:US
Practice Address - Phone:305-763-9079
Practice Address - Fax:305-901-1797
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019535800Medicaid