Provider Demographics
NPI:1740391754
Name:ARONSON, KEITH ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ROBERT
Last Name:ARONSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 S PUGH ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5342
Mailing Address - Country:US
Mailing Address - Phone:814-861-1329
Mailing Address - Fax:
Practice Address - Street 1:119 S BURROWES ST
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-3863
Practice Address - Country:US
Practice Address - Phone:814-235-5588
Practice Address - Fax:814-238-1875
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015110103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical