Provider Demographics
NPI:1801312020
Name:KEENEY, JUDITH LEE (BCBA)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:LEE
Last Name:KEENEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:LEE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QASP-S
Mailing Address - Street 1:316 MID VALLEY CTR STE 186
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8516
Mailing Address - Country:US
Mailing Address - Phone:800-991-6070
Mailing Address - Fax:800-991-6071
Practice Address - Street 1:185 MITTIE HADDOCK DRIVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326
Practice Address - Country:US
Practice Address - Phone:800-991-6070
Practice Address - Fax:800-991-6071
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst