NPI 1093295032 · live from the CMS NPI Registry
Kaitlyn Bradshaw, BCBA
Behavior Analyst in Rock Valley, IA. National Provider Identifier 1093295032, active.
NPI record
| NPI | 1093295032 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 745 10th St Ste C, Rock Valley, IA 51247 |
| Practice phone | 712-454-3484 |
| Mailing address | 1105 W Russell St, Sioux Falls, SD 57104 |
| Enumerated | August 20, 2018 |
| Last updated | July 12, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-57026 (LA) |
| Behavior Analyst primary | 103K00000X | 1-20-45677 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.