Healthcare Provider Details

I. General information

NPI: 1982964482
Provider Name (Legal Business Name): JUDITH ANN GUESS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 N MAIN ST
BRYAN OH
43506-1316
US

IV. Provider business mailing address

221 S MAIN ST
BRYAN OH
43506-1759
US

V. Phone/Fax

Practice location:
  • Phone: 419-392-7024
  • Fax: 410-854-2215
Mailing address:
  • Phone: 419-392-7024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6910
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: