NPI 1073264982

Jacob Gary Dyer

Practitioner Counselor Eagle, ID

Practice location

Address: 1197 S River Flow Way, Eagle, ID 83616-6324
Phone: (208) 921-0796

Registered specialties

Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101Y00000X Licence COUI-8653 (ID)

Other Counselor providers in Idaho →

Registry record

NPI: 1073264982
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jan 2022
Record last updated: 12 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.