Provider Demographics
NPI:1285877944
Name:CRUZ, YULEMA (BCBA)
Entity type:Individual
Prefix:
First Name:YULEMA
Middle Name:
Last Name:CRUZ
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 1:3301 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7721
Mailing Address - Country:US
Mailing Address - Phone:954-262-7365
Mailing Address - Fax:954-262-3683
Practice Address - Street 1:3301 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7721
Practice Address - Country:US
Practice Address - Phone:954-262-7365
Practice Address - Fax:954-262-3683
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-06-3120103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst