MEDICARE: MS. BARBARA LUZANNE WALDNER LMFT

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
1	106H00000X	Marriage & Family Therapist	409	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	144166	OTHER	CO	VALUE OPTIONS INSURANCE C

General Provider Information

NPI Number	:	1801975487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA LUZANNE WALDNER LMFT

Provider Business Mailing Address
First Line	:	2163 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1507
Country	:	US
Telephone Number	:	719-660-8973
Fax Number	:	719-632-6195

Provider Business Practice Location Address
First Line	:	2163 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1507
Country	:	US
Telephone Number	:	719-660-8973
Fax Number	:	719-632-6195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	04/20/2021

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