Dale Forman
NPI #1023432457 in Eagle River, Alaska
Provider Information
- NPI Number
- 1023432457
- Entity Type
- Individual
- Name
- Dale Forman
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Analyst
- Enumeration Date
- Feb 5, 2014
- Last Updated
- Feb 5, 2014
Practice Location
- Address
- 12836 OLD GLENN HWY
- City
- Eagle River
- State
- Alaska
- ZIP Code
- 99577-7041
- Phone
- (907) 726-5330
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Analyst |
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