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NPI Code Detail

MEDICARE: MR. PHILIP D. STOFFLE MS, LPC

MEDICARE:  MR. PHILIP D. STOFFLE  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-5116ID

General Provider Information

NPI Number : 1588908313
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PHILIP D. STOFFLE MS, LPC
Provider Business Mailing Address
First Line : 2971 E COPPER POINT DR
Second Line : SUITE 100
City : MERIDIAN
State : ID
Zip : 83642-5101
Country : US
Telephone Number : 208-461-4438
Fax Number :
Provider Business Practice Location Address
First Line : 2971 E COPPER POINT DR
Second Line : SUITE 100
City : MERIDIAN
State : ID
Zip : 83642-5101
Country : US
Telephone Number : 208-461-4438
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2012
Last Update Date : 11/16/2012

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Directions to “ MR. PHILIP D. STOFFLE MS, LPC” Practice Location

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