Provider Demographics
NPI:1639408206
Name:ALPINE BIOFEEDBACK THERAPY, LLC
Entity Type:Organization
Organization Name:ALPINE BIOFEEDBACK THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIS
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TEIS
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV,BCIAC
Authorized Official - Phone:303-522-1127
Mailing Address - Street 1:1776 S JACKSON ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3801
Mailing Address - Country:US
Mailing Address - Phone:303-522-1127
Mailing Address - Fax:303-758-0833
Practice Address - Street 1:1776 S JACKSON ST
Practice Address - Street 2:SUITE 205
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3801
Practice Address - Country:US
Practice Address - Phone:303-522-1127
Practice Address - Fax:303-758-0833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPINE MEDICAL LEGAL CONSULTING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COB4883101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty