Individual
MR. DALLAS WAYNE PAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LCPC
Contact information
Practice address
2819 BRISTOL AVE, CALDWELL, ID 83605-1629
(208) 936-0010
Mailing address
2819 BRISTOL AVE, CALDWELL, ID 83605-1629
(208) 936-0010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-4441
ID
101YP2500X
Professional Counselor
LCPC-4441
ID
Other
Enumeration date
06/12/2007
Last updated
04/08/2020
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