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NPI Code Detail

MEDICARE: MELISSA KOHLER MS, LPC

MEDICARE:   MELISSA  KOHLER  MS, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC-5875ID

General Provider Information

NPI Number : 1275085169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA KOHLER MS, LPC
Provider Business Mailing Address
First Line : 13477 W BLUEBONNET DR
Second Line :
City : BOISE
State : ID
Zip : 83713-1341
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13477 W BLUEBONNET DR
Second Line :
City : BOISE
State : ID
Zip : 83713-1341
Country : US
Telephone Number : 541-420-5841
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2016
Last Update Date : 10/26/2016

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Directions to “ MELISSA KOHLER MS, LPC” Practice Location

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