Provider Demographics
NPI:1720631591
Name:KEIZER, ABIGAIL MG (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MG
Last Name:KEIZER
Suffix:
Gender:
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 68TH ST SE STE 201
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-7896
Mailing Address - Country:US
Mailing Address - Phone:231-668-4909
Mailing Address - Fax:
Practice Address - Street 1:1000 E PARIS AVE SE STE 160
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8313
Practice Address - Country:US
Practice Address - Phone:302-334-8251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician