Provider Demographics
NPI:1356745541
Name:GUMM PSYCHOLOGICAL SERVICES PC
Entity type:Organization
Organization Name:GUMM PSYCHOLOGICAL SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANEE
Authorized Official - Middle Name:BEATY
Authorized Official - Last Name:GUMM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-282-6655
Mailing Address - Street 1:1848 NORWOOD PLZ
Mailing Address - Street 2:SUITE 112
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3720
Mailing Address - Country:US
Mailing Address - Phone:817-282-6655
Mailing Address - Fax:817-282-6657
Practice Address - Street 1:1848 NORWOOD PLZ
Practice Address - Street 2:SUITE 112
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3720
Practice Address - Country:US
Practice Address - Phone:817-282-6655
Practice Address - Fax:817-282-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-16
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty