Provider Demographics
NPI:1639412174
Name:KEICHER, EMMA S (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:S
Last Name:KEICHER
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THOMPSON CENTER FOR AUTISM &
Mailing Address - Street 2:205 PORTLAND STREET
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65211-0001
Mailing Address - Country:US
Mailing Address - Phone:573-884-4660
Mailing Address - Fax:573-884-3195
Practice Address - Street 1:THOMPSON CENTER FOR AUTISM &
Practice Address - Street 2:205 PORTLAND STREET
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65211-0001
Practice Address - Country:US
Practice Address - Phone:573-884-4660
Practice Address - Fax:573-884-3195
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013009324103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst