Individual
STELA RISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6147
(208) 542-1026
Mailing address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6147
(208) 542-1026
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8861543
ID
Other
Enumeration date
02/10/2021
Last updated
01/14/2025
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