Provider Demographics
NPI:1699234872
Name:WRIGHT, ELLEN RENEE (BCABA)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:RENEE
Last Name:WRIGHT
Suffix:
Gender:
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 SKYLARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2380
Mailing Address - Country:US
Mailing Address - Phone:540-922-1110
Mailing Address - Fax:775-392-1245
Practice Address - Street 1:1809 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5236
Practice Address - Country:US
Practice Address - Phone:540-922-1110
Practice Address - Fax:775-392-1245
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
VA0134000275106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician