Healthcare Provider Details

I. General information

NPI: 1124960299
Provider Name (Legal Business Name): REGINA SILES BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43244 HAY RD
ASHBURN VA
20147-4029
US

IV. Provider business mailing address

44810 ASHLAR TER APT 301
ASHBURN VA
20147-4258
US

V. Phone/Fax

Practice location:
  • Phone: 703-574-5113
  • Fax:
Mailing address:
  • Phone: 484-587-4144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB699520
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: