LISA MICHELLE KOLLER

IDAHO FALLS, ID
NPI1467221093
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  13020)
Enumeration Date2023-12-22
Last Update Date2023-12-22
Business Address
LISA MICHELLE KOLLER SUDA
1810 W BROADWAY ST
IDAHO FALLS, ID 83402-5072
Phone number: 208-313-4550
Mailing Address
LISA MICHELLE KOLLER SUDA
1422 FREMONT AVE
IDAHO FALLS, ID 83402-1553
Phone number: 208-313-4550
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