Individual
DEONDRE L BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ICADC, SAP
Contact information
Practice address
3287 N MAPLE GROVE RD, BOISE, ID 83704-4215
(208) 350-0581
Mailing address
3287 N MAPLE GROVE RD, BOISE, ID 83704-4215
(208) 350-0581
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11564
ID
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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