Individual provider · Type 1 NPI
Lisa Michelle Koller, SUDA
Addiction (Substance Use Disorder) Counselor · Idaho Falls, ID
NPI number
1467221093
Active
Practice location
1810 W Broadway St
Idaho Falls, ID 83402-5072
Mailing address
1422 Fremont Ave
Idaho Falls, ID 83402-1553
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 13020 (ID) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
3 other providers at this address
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About NPI 1467221093
Lisa Michelle Koller, SUDA's National Provider Identifier is 1467221093, issued on Dec 22, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Idaho Falls, ID. The record was last updated on Dec 22, 2023.