| Active Pursuit Therapy | |
|
3350 W Americana Ter Ste 210b Boise ID 83706-2521 | |
| (208) 316-9381 | |
| Not Available |
| Full Name | Active Pursuit Therapy |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3350 W Americana Ter Ste 210b, Boise, Idaho |
| Authorized Official Name and Position | Candace Renee Cooper (PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2083169381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Pursuit Therapy 10416 W Petearana St Boise ID 83704-1251 Ph: (120) 831-6938 | Active Pursuit Therapy 3350 W Americana Ter Ste 210b Boise ID 83706-2521 Ph: (208) 316-9381 |
| NPI Number | 1154072023 |
|---|---|
| Provider Enumeration Date | 01/12/2022 |
| Last Update Date | 02/23/2022 |
| Certification Date | 02/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154072023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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