Individual
DIANE K. MOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1246 YELLOWSTONE AVE, SUITE C-6, POCATELLO, ID 83201-4374
(208) 234-8010
Mailing address
PO BOX 4944, POCATELLO, ID 83205-4944
(208) 236-1600
(208) 236-6695
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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