Provider Demographics
NPI:1871982470
Name:KEANE, ASHLEY A I (EDD, BCBA)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:A
Last Name:KEANE
Suffix:I
Gender:F
Credentials:EDD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-5335
Mailing Address - Country:US
Mailing Address - Phone:413-237-5176
Mailing Address - Fax:
Practice Address - Street 1:47 BAILEY DR
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-5335
Practice Address - Country:US
Practice Address - Phone:413-237-5176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-07-3252103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst