Kimberly Kay Bredberg-Beaner, BCBA

Individual provider Active NPI Behavior Analyst · Miles City, MT

NPI 1346847779 · NPPES record last updated Jan 6, 2021

Key facts

NPI
1346847779
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
PSY-BA-LIC-3394 (MT)
Practice address
2200 Box Elder St Ste 151
Miles City, MT 59301-5930
Phone
(406) 234-6034
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PSY-BA-LIC-3394MTMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X PSY-BA-LIC-3394 MT Yes

Addresses

Primary practice location

2200 Box Elder St Ste 151
Miles City, MT 59301-5930

Mailing address

210 N Custer Ave
Miles City, MT 59301-2722
Phone (140) 951-2562

Other identifiers

IdentifierTypeStateIssuer
1-20-45009OtherBACB

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address kbeaner@deapmt.org Direct

Other providers in Miles City, MT

All providers in Miles City, MT · Behavior Analyst in Montana

Sources for this page

Verify at the official NPI Registry.