IndividualActive
Dale Forman
NPI 1023432457 · Behavior Analyst · Eagle River, AK
Provider details
- NPI number
- 1023432457
- Entity type
- Individual
- Primary specialty
- Behavior AnalystBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 0-13-5716 (SC)
Practice location
12836 Old Glenn Hwy
Eagle River, AK 99577-7041
Phone: (907) 726-5330
Mailing address
13541 Charmley Cir
Eagle River, AK 99577
Registry dates
- Enumerated
- 2014-02-05
- Last updated
- 2014-02-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.