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Organization
COASTAL BEHAVIOR ANALYSIS, LLC
Active
Organization
COASTAL BEHAVIOR ANALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN PIERCE KELLER JR. BCBA (MANAGING MEMBER)
(772) 713-0108
Entity
Organization
Contact information
Practice address
1515 INDIAN RIVER BLVD, SUITE A210, VERO BEACH, FL 32960-5639
(774) 774-8224
(772) 774-8275
Mailing address
1515 INDIAN RIVER BLVD, SUITE A210, VERO BEACH, FL 32960-5639
(774) 774-8224
(772) 774-8275
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1042028
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003810000
—
FL
Enumeration date
03/28/2011
Last updated
06/15/2016
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