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General NPI Number Information
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NPI Number | 1497831432
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Entity Type | Individual
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Provider Name | C JEFFREY BISE LPC
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Gender | Male
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 409 GLENWOOD ST., STE 500
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City | GLEN ROSE
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State | TX
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Zip | 76043
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Country | US
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Telephone | 254-897-2202
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Fax | 254-897-2102
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Provider Business Mailing Address
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Address Line | PO BOX 806
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City | GLEN ROSE
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State | TX
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Zip | 76043-0806
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Country | US
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Telephone | 254-897-2202
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Fax | 254-897-2102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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