Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Kassidy Diane Wagner, BCBA

Individual provider Behavior Analyst · NPI 1376197723

Mrs. Kassidy Diane Wagner, BCBA is a Behavior Analyst in Eagle, Idaho. Licensed in Idaho. Registered with an NPI since 2019.

Licensed in
ID
In the registry since
2019
What do these letters mean?
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

449 S Fitness Pl
Eagle, ID 83616-6828
Phone: (208) 957-6301
Fax: (208) 228-0585
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 1-23-68300 (ID)

Record details

NPI number1376197723
Entity typeIndividual (Type 1)
GenderFemale
Credentials BCBA
Sole proprietorNo
NPI enumeratedJuly 24, 2019
Last updated in NPPESDecember 21, 2023
Certification dateDecember 21, 2023

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