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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