NPI 1962923995 · live from the CMS NPI Registry
Nichole Clark, BCBA
Behavior Analyst in Clive, IA. National Provider Identifier 1962923995, active.
NPI record
| NPI | 1962923995 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 13300 Hickman Rd Ste 110, Clive, IA 50325 |
| Practice phone | 515-987-8835 |
| Mailing address | 3418 Kingman Blvd Apt 2, Des Moines, IA 50311 |
| Enumerated | June 29, 2017 |
| Last updated | July 31, 2017 |
| 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.