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Organization
FAMILY MODEL BEHAVIOR THERAPY
Active
Organization
FAMILY MODEL BEHAVIOR THERAPY
Active
Other names
Family Model Behavior Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KEEGAN HART BCBA (CLINICAL DIRECTOR)
(818) 261-5580
Entity
Organization
Contact information
Practice address
18802 MANDAN STREET, #901, CANYON COUNTRY, CA 91351-3763
(818) 261-5580
(661) 367-7778
Mailing address
18802 MANDAN STREET, #901, CANYON COUNTRY, CA 91351-3763
(818) 261-5580
(661) 367-7778
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18352
CA
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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