NPI 1023375045 · live from the CMS NPI Registry
Alice Marie Blyth, MA, LPC, BCBA, LBA
Behavior Analyst in Riverside, MO. National Provider Identifier 1023375045, active.
NPI record
| NPI | 1023375045 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 3403 N Belton Ave, Riverside, MO 64150 |
| Practice phone | 816-863-4542 |
| Enumerated | April 15, 2012 |
| Last updated | April 15, 2012 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | 2010007552 (MO) |
| Behavior Analyst primary | 103K00000X | 2012010600 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.