Provider Information for 1124742515
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
LOGAN RYAN KOHLER LPC
Sex: Male
NPI: 1124742515
Last Updated: 2022-09-28
Certification Date: 2022-09-28
Certification Date: 2022-09-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1124742515 | ||||||||
| Enumeration Date | 2022-09-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2176 E FRANKLIN RD STE 100 MERIDIAN, ID 83642-8009 United States Phone: 208-515-7661 | Fax: | ||||||||
| Primary Practice Address | 2176 E FRANKLIN RD STE 100 MERIDIAN, ID 83642-8009 United States Phone: 208-515-7661 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|