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General NPI Number Information
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NPI Number | 1043572225
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Entity Type | Organization
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Legal Business Name | KRISTA M. BRITTAIN, PSYD, INC
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 3408 WOODLAND AVE SUITE 102
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City | WEST DES MOINES
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State | IA
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Zip | 50266-6506
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Country | US
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Telephone | 515-225-2015
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Fax | 515-225-1744
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Provider Business Mailing Address
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Address Line | 3408 WOODLAND AVE SUITE 102
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City | WEST DES MOINES
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State | IA
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Zip | 50266-6506
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Country | US
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Telephone | 515-225-2015
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Fax | 515-225-1744
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Authorized Official
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Title or Position | PRESIDENT, CLINICAL PSYCHOLOGIST
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Name | DR. KRISTA M BRITTAIN
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Credential | PSY.D.
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Telephone | 515-225-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001192
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License Number State | IA
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