Provider Demographics
NPI:1659051779
Name:MCKEEBY, KATHLEEN (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MCKEEBY
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4846 AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-4504
Mailing Address - Country:US
Mailing Address - Phone:517-667-0679
Mailing Address - Fax:
Practice Address - Street 1:4846 AIRLINE RD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-4504
Practice Address - Country:US
Practice Address - Phone:517-667-0679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401002133103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst