Provider Demographics
NPI:1629853296
Name:BELTRAN, KEREN (RBT)
Entity Type:Individual
Prefix:
First Name:KEREN
Middle Name:
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 ADVENTIST BLVD NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35896-0001
Mailing Address - Country:US
Mailing Address - Phone:978-751-1994
Mailing Address - Fax:
Practice Address - Street 1:1690 BELTLINE RD SW UNIT B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5505
Practice Address - Country:US
Practice Address - Phone:256-686-3169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst