Provider Demographics
NPI:1922436328
Name:TINCHER THERAPY SERVICES
Entity Type:Organization
Organization Name:TINCHER THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIVIEN
Authorized Official - Middle Name:WATTS
Authorized Official - Last Name:TINCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CDCII, MAC,
Authorized Official - Phone:907-696-8462
Mailing Address - Street 1:10928 EAGLE RIVER RD
Mailing Address - Street 2:#140
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8038
Mailing Address - Country:US
Mailing Address - Phone:907-696-8462
Mailing Address - Fax:907-696-8492
Practice Address - Street 1:10928 EAGLE RIVER RD
Practice Address - Street 2:#140
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-8038
Practice Address - Country:US
Practice Address - Phone:907-696-8462
Practice Address - Fax:907-696-8492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK117261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1518071554OtherNPI