NPI 1790490456 · live from the CMS NPI Registry
Brittany L Fraser
Behavior Analyst in Clive, IA. National Provider Identifier 1790490456, active.
NPI record
| NPI | 1790490456 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 |
| Enumerated | January 17, 2023 |
| Last updated | June 12, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.