Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PRO ACTIVE ADVANTAGE, LLC
Active OrganizationRehabilitation Psychologist · BURLEY, ID
Registration Details
- NPI Number
- 1124148176
- Provider Type
- Organization
- NPI Issued
- Mar 30, 2007 (19.060815162292 yrs)
- Last Updated
- Sep 15, 2021
Practice Information
- Address
-
1369 E 16TH ST STE 2BURLEY, ID, 833182008Browse ID providers · Browse ZIP 83318
- Phone
- 2088783423
- Fax
- 2088783424
- Primary Specialty
-
Rehabilitation Psychologist
103TR0400X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.