Provider Demographics
NPI:1619261302
Name:SMITH, GINGER REBECCA (LICENSED PROFESSIONA)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:REBECCA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LICENSED PROFESSIONA
Other - Prefix:MISS
Other - First Name:GINGER
Other - Middle Name:REBECCA
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804
Mailing Address - Country:US
Mailing Address - Phone:325-643-1721
Mailing Address - Fax:325-646-7627
Practice Address - Street 1:408 MULBERRY
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801
Practice Address - Country:US
Practice Address - Phone:325-646-9574
Practice Address - Fax:325-643-1299
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64834101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor