Provider Demographics
NPI:1558705384
Name:BEILOVEI, EVE CHANTELLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:EVE
Middle Name:CHANTELLE
Last Name:BEILOVEI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:JEAN
Other - Last Name:BURNHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5095 VALMONT RD APT A
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2764
Mailing Address - Country:US
Mailing Address - Phone:612-270-1358
Mailing Address - Fax:
Practice Address - Street 1:75 MANHATTAN DR STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-4251
Practice Address - Country:US
Practice Address - Phone:719-362-0778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021382101YM0800X
MNMT3400292225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health