Individual
TAYLOR GRACE KEENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA
Contact information
Practice address
19800 VILLAGE OFFICE CT, #104, BEND, OR 97702-1872
(541) 306-3483
Mailing address
PO BOX 1432, BEND, OR 97709-1432
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-25289
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500690196
—
OR
Enumeration date
07/30/2015
Last updated
05/23/2017
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