Individual
DEAN CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, IS, BIS
Contact information
Practice address
4039 CARPENTER LN, LEWISTON, ID 83501-5227
(208) 790-4491
Mailing address
4039 CARPENTER LN, LEWISTON, ID 83501-5227
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
ID
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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