Provider Demographics
NPI:1003937202
Name:BRITTAIN-DIAL, KRISTA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:M
Last Name:BRITTAIN-DIAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:950 OFFICE PARK RD
Mailing Address - Street 2:STE 221
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2548
Mailing Address - Country:US
Mailing Address - Phone:515-868-2753
Mailing Address - Fax:
Practice Address - Street 1:950 OFFICE PARK RD STE 221
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2548
Practice Address - Country:US
Practice Address - Phone:515-868-2753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001192103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical