| Lisa Michelle Koller, SUDA | |
|
1810 W Broadway St, Idaho Falls, ID 83402-5072 | |
| (208) 313-4550 | |
| Not Available |
| Full Name | Lisa Michelle Koller |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1810 W Broadway St, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467221093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 13020 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Michelle Koller, SUDA 1422 Fremont Ave, Idaho Falls, ID 83402-1553 Ph: (208) 313-4550 | Lisa Michelle Koller, SUDA 1810 W Broadway St, Idaho Falls, ID 83402-5072 Ph: (208) 313-4550 |
Desiree Jenks-asay, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 615 Hoopes Ave, Idaho Falls, ID 83401 Phone: 208-542-0352 | |
Steven Orme, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 545 Shoup Ave, Idaho Falls, ID 83402 Phone: 208-351-1447 | |
Mr. Jorge Padron, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 543 3rd St, Idaho Falls, ID 83401 Phone: 208-522-6925 Fax: 208-522-6934 | |
Zachary Wixom, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 150 Shoup Ave, Idaho Falls, ID 83402 Phone: 208-528-5712 | |
Jennie R Nelson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 E 16th St, Idaho Falls, ID 83404 Phone: 208-523-6727 | |
Mr. Richard A Troyer, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3760 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-524-4953 Fax: 208-524-7335 | |
Kirk Thiemann, Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 E 16th St, Idaho Falls, ID 83404 Phone: 208-523-6727 |