Provider Demographics
NPI:1205858073
Name:LUDWIG, GAIL ROBERTA (MSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:ROBERTA
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 PERRY HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9213
Mailing Address - Country:US
Mailing Address - Phone:724-759-7500
Mailing Address - Fax:724-759-7600
Practice Address - Street 1:10475 PERRY HWY STE 300
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9213
Practice Address - Country:US
Practice Address - Phone:724-759-7500
Practice Address - Fax:724-759-7600
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014677104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker