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General NPI Number Information
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NPI Number | 1528555679
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Entity Type | Individual
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Provider Name | KAITLYN MCKEON MSED, BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/15/2018
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 7220 W JEFFERSON AVE STE 202
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City | LAKEWOOD
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State | CO
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Zip | 80235-2023
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Country | US
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Telephone | 516-698-9740
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Fax |
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Provider Business Mailing Address
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Address Line | 11536 BRIARWOOD LN
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City | PARKER
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State | CO
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Zip | 80138-7181
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Country | US
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Telephone | 516-698-9740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-52702
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | CO
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