Doctor Name: | MR. BOBBY GUINN MEDFORD |
NPI Number: | 1902882970 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.P.C. |
License Number: | 18298 |
Business Practice Address: | 920 Johnson St. Hartley, TX - 79044 |
Business Phone Number: | 8063615011 |
Business Fax Number: | |
Mailing Address: | Po Box 268, HARTLEY |
State: | TX |
Postal Code: | 790440268 |
Phone Number: | 8063615011 |
Fax Number: | 8063615011 |
NPI Enumeration Date: | 12/21/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 18298 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |