Provider Demographics
NPI:1740744697
Name:KEYSTONE APPLIED BEHAVIOR ANALYSIS, LLC
Entity Type:Organization
Organization Name:KEYSTONE APPLIED BEHAVIOR ANALYSIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SETZLER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:412-684-2220
Mailing Address - Street 1:272 FISK ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2872
Mailing Address - Country:US
Mailing Address - Phone:412-684-2220
Mailing Address - Fax:
Practice Address - Street 1:272 FISK ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-2872
Practice Address - Country:US
Practice Address - Phone:412-684-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty