person
Lisa Michelle Koller, SUDA
Addiction (Substance Use Disorder) Counselor in Idaho Falls, Idaho
NPI 1467221093

Lisa Michelle Koller is an Addiction (Substance Use Disorder) Counselor based in Idaho Falls, ID and is specialized in Addiction (Substance Use Disorder). Lisa Michelle Koller practices in Idaho Falls, ID and has the professional credentials of SUDA. The NPI Number for Lisa Michelle Koller is 1467221093 and holds a License No. 13020 (Idaho).

The current practice location address for Lisa Michelle Koller is 1810 W Broadway St, Idaho Falls, ID and can be reached out via phone at 208-313-4550.

Location: 1810 W Broadway St, Idaho Falls, ID, 83402-1553
person
Provider Profile Details
NPI Number
1467221093
Provider Name
Lisa Michelle Koller
Credential
SUDA
Provider Entity Type
Individual
Gender
Female
Address
1810 W Broadway St, Idaho Falls, ID, 83402-1553
Phone Number
208-313-4550
Fax Number
Provider Enumeration Date
12/22/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1810 W Broadway St
City
State
Zip
83402-5072
Phone Number
208-313-4550
Fax Number
person
Provider Business Mailing Address Details
Address
1810 W Broadway St
City
State
Zip
83402-5072
Phone Number
208-313-4550
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
13020 (Idaho)
Definition
Definition to come...
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