NPI 1760870661 · live from the CMS NPI Registry
Brad Dickey, BCBA
Behavior Analyst in Jackson, WY. National Provider Identifier 1760870661, active.
NPI record
| NPI | 1760870661 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 536 E Kelly Ave, Jackson, WY 83001 |
| Practice phone | 715-829-5195 |
| Mailing address | Po Box 11231, Jackson, WY 83002 |
| Enumerated | December 30, 2014 |
| Last updated | September 20, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 1-12-11844 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.