Jacob Gary Dyer Valid NPI
Individual provider · Counselor · Eagle, ID
- NPI
- 1073264982
- Type
- Individual (Type 1)
- Primary specialty
- Counselor
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101Y00000X
- License number
- COUI-8653 (ID)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2022-01-12
- Last updated
- 2022-01-12
Practice location
1197 S River Flow Way
Eagle, ID 83616-6324
(208) 921-0796