Individual
DALLIN RICHARD BEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 LILAC ST APT 4, BLACKFOOT, ID 83221-1738
(435) 744-3535
Mailing address
140 LILAC ST APT 4, BLACKFOOT, ID 83221-1738
(435) 744-3535
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/14/2023
Last updated
01/08/2024
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