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NPI Code Detail

MEDICARE: CIARA MAE KEETON

MEDICARE: CIARA MAE KEETON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-25-80082CO

General Provider Information

NPI Number : 1861998833
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIARA MAE KEETON
Provider Business Mailing Address
First Line : 5475 MARK DABLING BLVD STE 102
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3847
Country : US
Telephone Number : 719-641-0448
Fax Number :
Provider Business Practice Location Address
First Line : 5475 MARK DABLING BLVD STE 102
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3847
Country : US
Telephone Number : 719-641-0448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2018
Last Update Date : 04/02/2025

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Directions to “ CIARA MAE KEETON ” Practice Location

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