Provider Demographics
NPI:1700425667
Name:KEITH, YAHAIRA CAROLINA (BCBA)
Entity Type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:CAROLINA
Last Name:KEITH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:YAHAIRA
Other - Middle Name:CAROLINA
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3047 FALL WAY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3233
Mailing Address - Country:US
Mailing Address - Phone:210-842-7370
Mailing Address - Fax:
Practice Address - Street 1:3201 CHERRY RIDGE ST STE B205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4825
Practice Address - Country:US
Practice Address - Phone:210-313-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-24
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-19-40059103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst