Provider Demographics
NPI:1275761470
Name:LUDWIG, GAIL ANN (MA CCC)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ANN
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:MA CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9606 TIERRA GRANDE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6501
Mailing Address - Country:US
Mailing Address - Phone:760-390-0373
Mailing Address - Fax:760-747-0817
Practice Address - Street 1:9606 TIERRA GRANDE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6501
Practice Address - Country:US
Practice Address - Phone:760-390-0373
Practice Address - Fax:760-747-0817
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist