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General NPI Number Information
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NPI Number | 1477011658
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Entity Type | Individual
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Provider Name | GAYLENE LUDWIG LPC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 514 28 1/4 RD UNIT 3
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-4961
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Country | US
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Telephone | 970-216-5524
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Fax |
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Provider Business Mailing Address
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Address Line | 2418 SANDRIDGE CT
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City | GRAND JUNCTION
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State | CO
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Zip | 81507-1653
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Country | US
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Telephone | 970-216-5524
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0016902
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0016902
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License Number State | CO
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