Individual
LISA NESTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4460 KINGS WAY STE 2, CHUBBUCK, ID 83202-1900
(208) 237-1711
(208) 237-5192
Mailing address
4460 KINGS WAY STE 2, CHUBBUCK, ID 83202-1900
(208) 237-1711
(208) 237-5192
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC3693
ID
Other
Enumeration date
10/10/2006
Last updated
07/09/2007
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