Provider Demographics
NPI:1497555932
Name:WARDLE, KAREN (RBT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WARDLE
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 1:7640 GREENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NOKESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20181-5804
Mailing Address - Country:US
Mailing Address - Phone:703-470-1496
Mailing Address - Fax:
Practice Address - Street 1:5306 LEE HWY
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-9380
Practice Address - Country:US
Practice Address - Phone:888-574-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-24-392742106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician