Individual
KEITH EVERETT BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
2001 W COURT ST STE A, WINNFIELD, LA 71483-4601
(318) 209-4033
(318) 209-4043
Mailing address
6214 COTY DR, ALEXANDRIA, LA 71303-2094
(318) 209-4033
(318) 209-4043
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-435
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L-435
LOUISIANA BEHAVIOR ANALYST CERTIFICATION BOARD
LA
Enumeration date
03/26/2020
Last updated
03/26/2020
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