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NPI Code Detail

MEDICARE: GABRIELLE WARDLAW-PFAFF LPC

MEDICARE:   GABRIELLE  WARDLAW-PFAFF  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401017600MI

General Provider Information

NPI Number : 1235765041
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELLE WARDLAW-PFAFF LPC
Provider Business Mailing Address
First Line : 220 S MAIN ST
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-2676
Country : US
Telephone Number : 248-671-6649
Fax Number :
Provider Business Practice Location Address
First Line : 220 S MAIN ST
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-2676
Country : US
Telephone Number : 248-671-6649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2020
Last Update Date : 01/16/2026

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Directions to “ GABRIELLE WARDLAW-PFAFF LPC” Practice Location

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