MEDICARE: DR. KRISTA M BRITTAIN-DIAL PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	001192	IA

General Provider Information

NPI Number	:	1003937202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTA M BRITTAIN-DIAL PSY.D.

Provider Business Mailing Address
First Line	:	950 OFFICE PARK RD
Second Line	:	STE 221
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2548
Country	:	US
Telephone Number	:	515-868-2753
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 OFFICE PARK RD STE 221
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2548
Country	:	US
Telephone Number	:	515-868-2753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	03/17/2018

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