Individual
LEE ANNE KOELZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, CPI, CPSS
Contact information
Practice address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
(208) 524-0636
Mailing address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
(208) 524-0636
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
11/28/2023
Last updated
11/30/2023
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