Individual
MRS. KIMBERLY KAY BREDBERG-BEANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2200 BOX ELDER ST STE 151, MILES CITY, MT 59301-5930
(406) 234-6034
Mailing address
210 N CUSTER AVE, MILES CITY, MT 59301-2722
(140) 951-2562
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
PSY-BA-LIC-3394
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-45009
BACB
—
Enumeration date
10/08/2020
Last updated
01/06/2021
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