Provider Demographics
NPI:1871694281
Name:PSYCHOLOGICAL AND BIOFEEDBACK SERVICES INC
Entity type:Organization
Organization Name:PSYCHOLOGICAL AND BIOFEEDBACK SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-887-0985
Mailing Address - Street 1:4732 N ORACLE RD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-1674
Mailing Address - Country:US
Mailing Address - Phone:520-887-0985
Mailing Address - Fax:520-887-5338
Practice Address - Street 1:4732 N ORACLE RD
Practice Address - Street 2:SUITE 316
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1674
Practice Address - Country:US
Practice Address - Phone:520-887-0985
Practice Address - Fax:520-887-5338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ274103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty