Individual
DAVID DEAN DELAWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
413 N ALLUMBAUGH ST STE 102, BOISE, ID 83704-9219
(208) 389-2166
(208) 343-4458
Mailing address
413 N ALLUMBAUGH ST STE 102, BOISE, ID 83704-9219
(208) 389-2166
(208) 343-4458
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY251
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010016144
REGENCE BLUE SHIELD OF ID
ID
01
—
N2514
BLUE CROSS OF IDAHO
ID
Enumeration date
09/16/2006
Last updated
10/11/2019
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