Provider Demographics
NPI:1902645146
Name:CLAUSON, DEANNA LOUISE (NBC-HWC, FMCHC)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LOUISE
Last Name:CLAUSON
Suffix:
Gender:F
Credentials:NBC-HWC, FMCHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638-3046
Mailing Address - Country:US
Mailing Address - Phone:970-485-3815
Mailing Address - Fax:
Practice Address - Street 1:201 E PARK ST
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-3832
Practice Address - Country:US
Practice Address - Phone:970-485-3815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach