Healthcare Provider Details

I. General information

NPI: 1861986671
Provider Name (Legal Business Name): BONNIE JO KEYS LBA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BONNIE JO KEYS

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CITADEL DR E STE 100
COLORADO SPRINGS CO
80909-5358
US

IV. Provider business mailing address

5165 BALSAM ST
COLORADO SPRINGS CO
80923-5144
US

V. Phone/Fax

Practice location:
  • Phone: 720-706-3396
  • Fax:
Mailing address:
  • Phone: 903-603-0602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-1938532
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBEH-001067
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: