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NPI Code Detail

MEDICARE: GUMM PSYCHOLOGICAL SERVICES, PC

MEDICARE: GUMM PSYCHOLOGICAL SERVICES, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist
2106H00000XMarriage & Family Therapist
3103T00000XPsychologist

General Provider Information

NPI Number : 1386829711
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUMM PSYCHOLOGICAL SERVICES, PC
Provider Business Mailing Address
First Line : 1848 NORWOOD PLAZA
Second Line : SUITE 112
City : HURST
State : TX
Zip : 76054-3751
Country : US
Telephone Number : 817-282-6655
Fax Number : 817-282-6657
Provider Business Practice Location Address
First Line : 1848 NORWOOD PLAZA
Second Line : SUITE 112
City : HURST
State : TX
Zip : 76054-3751
Country : US
Telephone Number : 817-282-6655
Fax Number : 817-282-6657
Authorized Official
Title or Position : PSYCHOLOGIST/OWNER
Name : RANEE B GUMM
Credential : PHD
Telephone Number : 817-282-6655
Provider Enumeration Date : 01/03/2008
Last Update Date : 03/11/2014

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Directions to “GUMM PSYCHOLOGICAL SERVICES, PC ” Practice Location

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