Individual
JENNIFER DEDIOS-COILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1032 JULIENE WAY, MOSCOW, ID 83843-7833
(209) 271-2762
Mailing address
1032 JULIENE WAY, MOSCOW, ID 83843-7833
(209) 271-2762
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
1234567
ID
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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