Provider Demographics
NPI:1760813885
Name:SPIELMANN, KERI (BCBA)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:SPIELMANN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ETHAN ALLEN HWY
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2826
Mailing Address - Country:US
Mailing Address - Phone:203-559-7023
Mailing Address - Fax:
Practice Address - Street 1:900 ETHAN ALLEN HWY
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2826
Practice Address - Country:US
Practice Address - Phone:203-559-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-01
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-13-14699103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst