Provider Information for 1821722448
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Mrs. TRACY WATFORD LUDEWIG LPC
Sex: Female
NPI: 1821722448
Last Updated: 2022-07-11
Certification Date: 2022-07-11
Certification Date: 2022-07-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1821722448 | ||||||||||||
| Enumeration Date | 2022-07-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 600 TIMBERLAND DR WOODVILLE, TX 75979-4209 United States Phone: 979-450-5670 | Fax: | ||||||||||||
| Primary Practice Address | 600 WEST TIMBERLAND DRIVE WOODVILLE, TX 75979 United States Phone: 979-450-5670 | Fax: | ||||||||||||
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