Provider Demographics
NPI:1528755527
Name:DELAROSA, RICHARD (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:DELAROSA
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 N DYSART RD STE 180
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-3319
Mailing Address - Country:US
Mailing Address - Phone:480-297-0793
Mailing Address - Fax:
Practice Address - Street 1:13700 N DYSART RD STE 180
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-3319
Practice Address - Country:US
Practice Address - Phone:480-297-0793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-001113103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst