Provider Demographics
NPI:1093225039
Name:KEATING, SMRITI (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SMRITI
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RAVEN LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4968
Mailing Address - Country:US
Mailing Address - Phone:732-730-0700
Mailing Address - Fax:
Practice Address - Street 1:5 RAVEN LN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4968
Practice Address - Country:US
Practice Address - Phone:732-730-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst