NPI 1417464751 · live from the CMS NPI Registry
Jill Yvonne Bloss, BCBA
Behavior Analyst in Clive, IA. National Provider Identifier 1417464751, active.
NPI record
| NPI | 1417464751 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 1860 Nw 118th St Ste 100, Clive, IA 50325 |
| Practice phone | 515-402-4130 |
| Mailing address | 3105 Ep True Pkwy Apt 516, West Des Moines, IA 50265 |
| Enumerated | January 9, 2018 |
| Last updated | January 9, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.