| Doctor Name: | MR. JERRY LYNN HUCKABEE |
| NPI Number: | 1063464907 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M. ED. LPC |
| License Number: | 17322 |
| Business Practice Address: | 126 Byron St Stephenville, TX - 764014602 |
| Business Phone Number: | 2549655327 |
| Business Fax Number: | 2549655327 |
| Mailing Address: | 126 Byron St, STEPHENVILLE |
| State: | TX |
| Postal Code: | 764014602 |
| Phone Number: | 2549655327 |
| Fax Number: | 2549655327 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 02/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 17322 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |