Individual
ROBERT STAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
1970 E 17TH ST, IDAHO FALLS, ID 83404-8014
(208) 557-7500
Mailing address
1970 E 17TH ST, IDAHO FALLS, ID 83404-8014
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC2932
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010016389
BLUE SHIELD OF IDAHO
ID
01
—
Q5530
BLUE CROSS OF IDAHO
ID
Enumeration date
03/10/2008
Last updated
03/10/2008
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