Provider Demographics
NPI:1477927762
Name:KEENER, BRITTANY MAY (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MAY
Last Name:KEENER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9855 E LOUISIANA DR APT 102
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2448
Mailing Address - Country:US
Mailing Address - Phone:720-295-4208
Mailing Address - Fax:
Practice Address - Street 1:1200 W SOUTH BOULDER RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3546
Practice Address - Country:US
Practice Address - Phone:720-837-2348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-15-19793103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst