Individual
KAYLA WARDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6216 OLD KEENE MILL CT, SPRINGFIELD, VA 22152-2323
(571) 297-4308
(703) 992-0405
Mailing address
6216 OLD KEENE MILL CT, SPRINGFIELD, VA 22152-2323
(571) 297-4308
(703) 992-0405
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-178969
VA
106S00000X
Behavior Technician
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Other
Enumeration date
08/20/2021
Last updated
05/24/2023
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