Keenen, Taylor Grace
Keenen, Taylor Grace is an individual health care provider with primary practice located at 19800 Village Office Ct #104, Bend OR 97702-1872. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Keenen, Taylor Grace can be contacted via phone (541) 306-3483.Contact Information
Primary practice address
19800 Village Office Ct #104
Bend OR 97702-1872
Phone: (541) 306-3483
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 1-17-25289 | Oregon |
Profile Details
| NPI number | 1083090153 |
|---|---|
| LBN Legal business name | Keenen, Taylor Grace |
| Credentials | M.ED, BCBA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2015 |
| Last updated | May 23rd, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083090153 | NPPES |
| Oregon | MEDICAID | 500690196 |
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