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Individual

DR. SUSAN D GIFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D, FPPR, FICPP

Contact information

Practice address
3508 HIGHWAY 121, BEDFORD, TX 76021
(817) 858-6745
(271) 571-9265
Mailing address
3508 HIGHWAY 121, BEDFORD, TX 76021
(817) 858-6745
(817) 571-9265

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
22020
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RC90
BCBS
TX
Enumeration date
03/27/2007
Last updated
07/08/2007
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