Individual
GREGORY M DEITCHLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA L.M.F.T., L.P.C.,
Contact information
Practice address
3061 S. MERIDIAN RD., SUITE 100, MERIDIAN, ID 83642
(208) 350-0330
(208) 576-6915
Mailing address
3061 S. MERIDIAN RD., SUITE 100, MERIDIAN, ID 83642
(208) 350-0330
(208) 576-6915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-949
ID
101YP2500X
Professional Counselor
LPC949
ID
106H00000X
Marriage & Family Therapist
Primary
LMFT2935
ID
Other
Enumeration date
10/30/2007
Last updated
01/28/2019
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