Provider Demographics
NPI:1295225803
Name:KEINZ, KAYDE LOU (BCBA)
Entity Type:Individual
Prefix:
First Name:KAYDE
Middle Name:LOU
Last Name:KEINZ
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 1:7353 W GRANT RANCH BLVD APT 1033
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2654
Mailing Address - Country:US
Mailing Address - Phone:319-899-6880
Mailing Address - Fax:
Practice Address - Street 1:7379 W GRANT RANCH BLVD APT 1921
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2666
Practice Address - Country:US
Practice Address - Phone:319-899-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-18-31537103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst