Provider Demographics
NPI:1023535077
Name:MAURER, GAYLYN GADDY (LPC)
Entity Type:Individual
Prefix:
First Name:GAYLYN
Middle Name:GADDY
Last Name:MAURER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 WILD PLUM DR
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1962
Mailing Address - Country:US
Mailing Address - Phone:713-203-3744
Mailing Address - Fax:
Practice Address - Street 1:1061 WILD PLUM DR
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1962
Practice Address - Country:US
Practice Address - Phone:713-203-3744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3219101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional