Provider Demographics
NPI:1699983098
Name:WAMPLER, RICHARD SCOTTEN (PHD, MSW)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:SCOTTEN
Last Name:WAMPLER
Suffix:
Gender:M
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MARRIAGE AND FAMILY THERAPY, APS
Mailing Address - Street 2:BOX 41162, TEXAS TECH UNIVERSITY
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79409-1162
Mailing Address - Country:US
Mailing Address - Phone:806-742-5050
Mailing Address - Fax:806-742-5033
Practice Address - Street 1:MARRIAGE AND FAMILY THERAPY, APS
Practice Address - Street 2:BOX 41162, TEXAS TECH UNIVERSITY
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79409-1162
Practice Address - Country:US
Practice Address - Phone:806-742-5050
Practice Address - Fax:806-742-5033
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24014103T00000X
104100000X
TX1894106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist