Pro Active Advantage, LLC
NPI #1225139298 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1225139298
- Entity Type
- Organization
- Organization Name
- Pro Active Advantage, LLC
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Sep 25, 2006
- Last Updated
- Aug 22, 2023
Practice Location
- Address
- 562 SHOUP AVE W
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-5029
- Phone
- (208) 734-0407
Authorized Official
- Name
- LISA COLWELL
- Title
- OFFICE MANAGER
- Phone
- (208) 734-0407
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
| Counselor - Mental Health — Mental Health |
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