Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 001192 | IA |
Y | 103TC0700X | Clinical Psychologist | 001192 | IA |
NPI | 1003937202 |
---|---|
Provider Name | Dr. Krista M Brittain-Dial |
First Address | West Des Moines, IA 50265-2548 |
Second Address | West Des Moines, IA 50265-2548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 17/03/2018 |