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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. KASSIDY DIANE WAGNER, BCBA

Active

Behavior Analyst · EAGLE, ID

Registration Details

NPI Number
1376197723
Provider Type
Individual
Gender
Female
NPI Issued
Jul 24, 2019 (6.7437791537796 yrs)
Last Updated
Dec 21, 2023
License
1-23-68300 (ID)

Practice Information

Address
449 S FITNESS PL
EAGLE, ID, 836166828
Browse ID providers · Browse ZIP 83616
Phone
2089576301
Fax
2082280585
Primary Specialty
Behavior Analyst
103K00000X

Other Behavior Analyst Providers in EAGLE, ID

Name Credential NPI
LEAH RUTLEDGE BCBA 1437445939
MR. ROBBIE EL FATTAL BCBA-D, LBA 1508118126
JAMIE ACHENBACH 1760845770
SHELBI MORRISON M.ED, BCBA 1568015683
RICHELLE VINCENT 1477229896
CAROLINE YOUNG 1194488643
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.