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Pro Active Advantage, Llc
Mental Health Counselor in Burley, Idaho
NPI 1073634713

Pro Active Advantage, Llc is a Mental Health Counselor based in Gooding, ID and is specialized in Mental Health. Pro Active Advantage, Llc practices in Burley, ID. The NPI Number for Pro Active Advantage, Llc is 1073634713 and holds a License No. (Idaho).

The current practice location address for Pro Active Advantage, Llc is 1369 E 16Th St Ste 2, Burley, ID and can be reached out via phone at 208-878-3423 and via fax at 208-878-3424.

Location: 1369 E 16Th St Ste 2, Burley, ID, 83330-6155
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073634713
Provider Name
Pro Active Advantage, Llc
Credential
Provider Entity Type
Organization
Address
1369 E 16Th St Ste 2, Burley, ID, 83330-6155
Phone Number
208-878-3423
Fax Number
208-878-3424
Provider Enumeration Date
04/02/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8073811 05 ID
institution
Provider Business Practice Location Address Details
Address
1369 E 16Th St Ste 2
City
Burley
State
Idaho
Zip
83318-2008
Phone Number
208-878-3423
Fax Number
208-878-3424
person
Provider Business Mailing Address Details
Address
1369 E 16Th St Ste 2
City
Burley
State
Idaho
Zip
83318-2008
Phone Number
208-878-3423
Fax Number
208-878-3424
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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