Provider Demographics
NPI:1588747968
Name:RAYBURN, JUDY (LPC)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:
Last Name:RAYBURN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4959
Mailing Address - Country:US
Mailing Address - Phone:214-536-0057
Mailing Address - Fax:214-975-9755
Practice Address - Street 1:202 N ALLEN DR STE E
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:214-536-0057
Practice Address - Fax:214-975-9755
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional