Provider Demographics
NPI:1982964482
Name:GUESS, JUDITH ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:GUESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:OH
Mailing Address - Zip Code:43506-1759
Mailing Address - Country:US
Mailing Address - Phone:419-392-7024
Mailing Address - Fax:
Practice Address - Street 1:126 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1316
Practice Address - Country:US
Practice Address - Phone:419-392-7024
Practice Address - Fax:410-854-2215
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6910103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist