Doctor Name: | MRS. JOANNE EVELYN DEYO |
NPI Number: | 1457623571 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LCSW-31240 |
Business Practice Address: | 1275 Riverside Ave Orofino, ID - 835446025 |
Business Phone Number: | 2084767483 |
Business Fax Number: | |
Mailing Address: | 1275 Riverside Ave, OROFINO |
State: | ID |
Postal Code: | 835446025 |
Phone Number: | 2084767483 |
Fax Number: | |
NPI Enumeration Date: | 02/06/2012 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LCSW-31240 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |