Provider Demographics
NPI:1417457284
Name:KEKER, LINDSAY J (BCBA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:J
Last Name:KEKER
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 1:307 OLD BRIDGE PLZ
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3107
Mailing Address - Country:US
Mailing Address - Phone:908-240-7192
Mailing Address - Fax:
Practice Address - Street 1:307 OLD BRIDGE PLZ
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3107
Practice Address - Country:US
Practice Address - Phone:908-240-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-18
Last Update Date:2018-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-15-19595103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst