Healthcare Provider Details
I. General information
NPI: 1477518348
Provider Name (Legal Business Name): PSYCHOLOGICAL & BIOFEEDBACK SERVICES OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 POTOMAC CIR STE. 265
AURORA CO
80011-6750
US
IV. Provider business mailing address
830 POTOMAC CIR STE. 265
AURORA CO
80011-6750
US
V. Phone/Fax
- Phone: 720-858-6403
- Fax: 720-859-7780
- Phone: 720-858-6403
- Fax: 720-859-7780
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YAVONNE
SEYMOUR
Title or Position: BILLING COLLECTOR
Credential:
Phone: 303-341-4785