Provider Demographics
NPI:1386867588
Name:GUILFORD, MARIE HUME (PHD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:HUME
Last Name:GUILFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:PERRY
Other - Last Name:HUME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3050 HIGHLAND OAKS TER # 1
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-3841
Mailing Address - Country:US
Mailing Address - Phone:850-224-5801
Mailing Address - Fax:850-224-6459
Practice Address - Street 1:3050 HIGHLAND OAKS TER # 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3841
Practice Address - Country:US
Practice Address - Phone:850-224-5801
Practice Address - Fax:850-224-6459
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5748103TB0200X, 103TF0200X, 103TC0700X
GA2150103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000766136DMedicaid