| Coastal Behavior Analysis, Llc | |
|
1515 Indian River Blvd Suite A210 Vero Beach FL 32960-5639 | |
| (774) 774-8224 | |
| (772) 774-8275 |
| Full Name | Coastal Behavior Analysis, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1515 Indian River Blvd, Vero Beach, Florida |
| Authorized Official Name and Position | John Pierce Keller (MANAGING MEMBER) |
| Authorized Official Contact | 7727130108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Behavior Analysis, Llc 1515 Indian River Blvd Suite A210 Vero Beach FL 32960-5639 Ph: (774) 774-8224 | Coastal Behavior Analysis, Llc 1515 Indian River Blvd Suite A210 Vero Beach FL 32960-5639 Ph: (774) 774-8224 |
| NPI Number | 1932408143 |
|---|---|
| Provider Enumeration Date | 03/28/2011 |
| Last Update Date | 06/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932408143 | NPI | - | NPPES |
| 003810000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1042028 (* (Not Available)) | Primary |
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