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Individual

ROBB DYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
4460 CENTRAL WAY, SUITE 2, CHUBBUCK, ID 83202-5095
(208) 237-1711
(208) 237-5192
Mailing address
4460 CENTRAL WAY, SUITE 2, CHUBBUCK, ID 83202-5095
(208) 237-1711
(208) 237-5192

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW25604
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807197600
ID
Enumeration date
01/28/2009
Last updated
01/28/2009
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