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MRS. KASSIDY DIANE WAGNER BCBA NPI 1376197723


NPI Information

NPI: 1376197723
Provider Name: MRS. KASSIDY DIANE WAGNER, BCBA
Classification: Behavior Analyst - 103K00000X
Entity Type: Individual
Address:
449 S FITNESS PL
EAGLE, ID
ZIP 83616
Phone: (208) 957-6301
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MRS. Kassidy Diane Wagner, BCBA is a behavior analyst in Eagle, ID. The provider is a behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. MRS. Kassidy Diane Wagner, BCBA NPI is 1376197723. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

449 S FITNESS PL
EAGLE, ID
ZIP 83616-828
Phone: (208) 957-6301
Fax: (208) 228-0585

The enumeration date for this NPI number is 7/24/2019 and was last updated on 12/21/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103K00000XBehavior Analyst1-23-68300IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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