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Individual

VANEEN KOHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.COUN, LPC

Contact information

Practice address
110 S 19TH AVE, POCATELLO, ID 83201-3312
(208) 234-4722
Mailing address
110 S 19TH AVE, POCATELLO, ID 83201-3312
(208) 234-4722

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC-5960
ID
101YM0800X
Mental Health Counselor
Primary
LPC-5960
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC-5960
LPC
ID
Enumeration date
09/24/2015
Last updated
09/24/2015
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