Individual
DELYN D PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 N 1100 W, BLACKFOOT, ID 83221-5152
(208) 380-3946
Mailing address
320 N 1100 W, BLACKFOOT, ID 83221-5152
(208) 380-3946
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00105855
—
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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