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General NPI Number Information
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NPI Number | 1588890438
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Entity Type | Organization
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Legal Business Name | CENTER FOR BIOFEEDBACK AND BEHAVIOR THERAPY
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 06/05/2009
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Provider Practice Location Address
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Address Line | 4530 BELTWAY DR
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City | ADDISON
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State | TX
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Zip | 75001-3707
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Country | US
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Telephone | 469-358-1309
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Fax |
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Provider Business Mailing Address
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Address Line | 4530 BELTWAY DR
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City | ADDISON
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State | TX
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Zip | 75001-3707
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Country | US
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Telephone | 469-358-1309
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. RUSTY LOZANO
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Credential | LPC
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Telephone | 469-358-1309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 60245
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License Number State | TX
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