Provider Demographics
NPI:1912631037
Name:WILLIAMS ORR, KESHYRA M (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KESHYRA
Middle Name:M
Last Name:WILLIAMS ORR
Suffix:
Gender:
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:KESHYRA
Other - Middle Name:M
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17216 SATICOY ST # 124
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-2103
Mailing Address - Country:US
Mailing Address - Phone:708-649-0100
Mailing Address - Fax:
Practice Address - Street 1:17216 SATICOY ST # 124
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-2103
Practice Address - Country:US
Practice Address - Phone:708-649-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-22-222761106S00000X
IL1-24-76420103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician