Provider Demographics
NPI:1316622483
Name:HOBBS, PRESTON RANDALL (PPC)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:RANDALL
Last Name:HOBBS
Suffix:
Gender:M
Credentials:PPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 CAPITOL AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4559
Mailing Address - Country:US
Mailing Address - Phone:073-631-9213
Mailing Address - Fax:
Practice Address - Street 1:1807 CAPITOL AVE STE 207
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4559
Practice Address - Country:US
Practice Address - Phone:073-631-9213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor