Healthcare Provider Details

I. General information

NPI: 1093587073
Provider Name (Legal Business Name): KEYONNA MINOR BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3723 OLD COURT RD STE 205
PIKESVILLE MD
21208-3926
US

IV. Provider business mailing address

1 UNION AVE UNIT 181
BALA CYNWYD PA
19004-3354
US

V. Phone/Fax

Practice location:
  • Phone: 443-339-6730
  • Fax:
Mailing address:
  • Phone: 888-344-5977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: