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General NPI Number Information
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NPI Number | 1336873876
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Entity Type | Organization
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Legal Business Name | PROACTIVE SOLUTIONS LLC
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 1050 QUEEN ST STE 100
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City | HONOLULU
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State | HI
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Zip | 96814-4130
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Country | US
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Telephone | 415-207-5887
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Fax | 808-240-2306
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Provider Business Mailing Address
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Address Line | 1050 QUEEN ST STE 100
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City | HONOLULU
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State | HI
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Zip | 96814-4130
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Country | US
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Telephone | 415-207-5887
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Fax | 808-240-2306
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Authorized Official
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Title or Position | FOUNDER/CLINICAL PSYCHOLOGIST
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Name | STEPHEN ANTHONY REYNOLDS
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Credential | PSYD
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Telephone | 415-207-5887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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