Healthcare Provider Details

I. General information

NPI: 1639545148
Provider Name (Legal Business Name): MEGAN JEANE KEYES BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10781 E CHERRY BEND RD
TRAVERSE CITY MI
49684-5249
US

IV. Provider business mailing address

1046 S WEST SILVER LAKE RD
TRAVERSE CITY MI
49685-8656
US

V. Phone/Fax

Practice location:
  • Phone: 231-268-0007
  • Fax: 231-525-3170
Mailing address:
  • Phone: 231-590-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-53434
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: