Healthcare Provider Details

I. General information

NPI: 1629400114
Provider Name (Legal Business Name): DEENA MARIE BRETON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEENA MARIE M BRETON-HARRIS MA

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 E ROOSEVELT AVE
NAMPA ID
83686-5353
US

IV. Provider business mailing address

1221 E ROOSEVELT AVE
NAMPA ID
83686-5353
US

V. Phone/Fax

Practice location:
  • Phone: 208-600-5291
  • Fax:
Mailing address:
  • Phone: 208-600-5291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT-10099
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: