Provider Demographics
NPI:1992338842
Name:VARA, DEBORAH
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:VARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11488 FARM HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:MARKHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22643-1800
Mailing Address - Country:US
Mailing Address - Phone:571-512-2173
Mailing Address - Fax:
Practice Address - Street 1:11488 FARM HOUSE RD
Practice Address - Street 2:
Practice Address - City:MARKHAM
Practice Address - State:VA
Practice Address - Zip Code:22643-1800
Practice Address - Country:US
Practice Address - Phone:571-512-2173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011988101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional