Provider Demographics
NPI:1730841792
Name:WARREN, LEE ANNA (RBT)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:ANNA
Last Name:WARREN
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 1:6175 MCCARTHY DR
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-2440
Mailing Address - Country:US
Mailing Address - Phone:916-467-2467
Mailing Address - Fax:
Practice Address - Street 1:1701 E PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2201
Practice Address - Country:US
Practice Address - Phone:804-261-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician