Individual
MS. PHYLLIS ROSE NODLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3709 N LOCUST GROVE RD STE 150, MERIDIAN, ID 83646-5924
(208) 577-7634
(208) 378-8389
Mailing address
3709 N LOCUST GROVE RD STE 150, MERIDIAN, ID 83646-5924
(208) 577-7634
(208) 378-8389
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-2984
ID
Other
Enumeration date
08/29/2008
Last updated
02/24/2011
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