Provider Demographics
NPI:1861986671
Name:KEYS, BONNIE JO (LBA, BCBA)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:JO
Last Name:KEYS
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:JO
Other - Last Name:KEYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5165 BALSAM ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-5144
Mailing Address - Country:US
Mailing Address - Phone:903-603-0602
Mailing Address - Fax:
Practice Address - Street 1:5165 BALSAM ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-5144
Practice Address - Country:US
Practice Address - Phone:036-030-6029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-17-37196106S00000X
CO1-1938532103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician