Organization
AVALON COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LONNIE M STAPP PH.D. (CLINICAL DIRECTOR)
(208) 771-5911
Entity
Organization
Contact information
Practice address
1250 W IRONWOOD DR STE 303, COEUR D ALENE, ID 83814-2682
(208) 366-5053
(208) 518-1258
Mailing address
1250 W IRONWOOD DR STE 303, COEUR D ALENE, ID 83814-2682
(208) 771-5911
(208) 518-1258
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2019
Last updated
08/24/2019
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