Healthcare Provider Details

I. General information

NPI: 1861281529
Provider Name (Legal Business Name): ANNA KINGSLEY KEENAN MA,BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 W GREENTREE DR STE 111
TEMPE AZ
85284-2715
US

IV. Provider business mailing address

10645 N TATUM BLVD STE C200
PHOENIX AZ
85028-3090
US

V. Phone/Fax

Practice location:
  • Phone: 623-263-3966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: