NPI 1023432457

Dale Forman

Practitioner Behavior Analyst Eagle River, AK

Practice location

Address: 12836 Old Glenn Hwy, Eagle River, AK 99577-7041
Phone: (907) 726-5330
Mailing address: 13541 Charmley Cir, Eagle River, AK 99577

Registered specialties

Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 103K00000X Licence 0-13-5716 (SC)

Other Behavior Analyst providers in Alaska →

Registry record

NPI: 1023432457
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Feb 2014
Record last updated: 5 Feb 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.