Provider Demographics
NPI:1306017710
Name:CURETON, DAWN MARIE (PSYD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:CURETON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2184 CHANNING WAY # 279
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-8034
Mailing Address - Country:US
Mailing Address - Phone:208-450-5308
Mailing Address - Fax:
Practice Address - Street 1:1329 AMMON PARK DR
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-4591
Practice Address - Country:US
Practice Address - Phone:208-450-5308
Practice Address - Fax:208-277-3764
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-202960101YM0800X
CAPSY 23464103TC0700X
IDPSY202960103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health