Healthcare Provider Details

I. General information

NPI: 1992515852
Provider Name (Legal Business Name): ADVANCED OUTCOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2025
Last Update Date: 01/11/2025
Certification Date: 01/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S WILSON ST
HILLSBORO KS
67063-1826
US

IV. Provider business mailing address

310 S WILSON ST
HILLSBORO KS
67063-1826
US

V. Phone/Fax

Practice location:
  • Phone: 620-266-6264
  • Fax:
Mailing address:
  • Phone: 620-266-6264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRIANA KAELIS JAMIESON
Title or Position: OWNER/BEHAVIOR ANALYST
Credential: BCBA
Phone: 712-299-0357