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Individual

MARY PAUL MOLLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
1151 HOSPITAL WAY BLDG D, POCATELLO, ID 83201-2763
(208) 233-3353
(208) 233-1923
Mailing address
1151 HOSPITAL WAY BLDG D, POCATELLO, ID 83201-2763
(208) 233-3353
(208) 233-1923

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-204
ID
106H00000X
Marriage & Family Therapist
LMFT-3003
ID

Other

Enumeration date
08/31/2006
Last updated
01/27/2016
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