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General NPI Number Information
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NPI Number | 1104834175
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Entity Type | Individual
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Provider Name | RANEE BEATY GUMM PHD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 124 W HARWOOD RD STE A
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City | HURST
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State | TX
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Zip | 76054-7016
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Country | US
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Telephone | 817-576-4222
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Fax | 817-576-2200
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Provider Business Mailing Address
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Address Line | 1848 NORWOOD PLAZA SUITE 112
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City | HURST
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State | TX
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Zip | 76054-3751
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Country | US
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Telephone | 817-282-6655
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Fax | 817-282-6657
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 22341
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1145
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 23241
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License Number State | TX
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