Provider Demographics
NPI:1053028431
Name:URENA, WARA (RBT)
Entity type:Individual
Prefix:
First Name:WARA
Middle Name:
Last Name:URENA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HAMPSTEAD CT NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3300
Mailing Address - Country:US
Mailing Address - Phone:571-888-9381
Mailing Address - Fax:
Practice Address - Street 1:44125 WOODRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8281
Practice Address - Country:US
Practice Address - Phone:703-665-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-22-208804106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician