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Organization
PROACTIVE INTERNATIONAL
Active
Organization
PROACTIVE INTERNATIONAL
Active
Other names
Prestonwood Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALAN FOWLER M.A., ED.D. (PRESIDENT)
(972) 248-4673
Entity
Organization
Contact information
Practice address
15400 KNOLL TRAIL DR, SUITE 109, DALLAS, TX 75248-3467
(972) 248-4673
(973) 392-9041
Mailing address
15400 KNOLL TRAIL DR, SUITE 109, DALLAS, TX 75248-3467
(972) 248-4673
(973) 392-9041
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
03231
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80752L
BLUE CROSS BLUE SHIELD #
TX
Enumeration date
11/14/2006
Last updated
08/22/2020
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