Provider Demographics
NPI:1033709076
Name:KAWAMURA, ADRIANA LORENA
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:LORENA
Last Name:KAWAMURA
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 1:2300 CLEAR CREEK RD STE 203
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5404
Mailing Address - Country:US
Mailing Address - Phone:254-433-5348
Mailing Address - Fax:
Practice Address - Street 1:860 CIRCLE WAY
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-1927
Practice Address - Country:US
Practice Address - Phone:737-770-9367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst