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General NPI Number Information
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NPI Number | 1003937202
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Entity Type | Individual
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Provider Name | KRISTA M BRITTAIN-DIAL PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 950 OFFICE PARK RD STE 221
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2548
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Country | US
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Telephone | 515-868-2753
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Fax |
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Provider Business Mailing Address
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Address Line | 950 OFFICE PARK RD STE 221
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2548
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Country | US
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Telephone | 515-868-2753
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 001192
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License Number State | IA
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