Individual
DR. GEOFFREY WAYNE LUDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
3300 ACADEMY AVE, PORTSMOUTH, VA 23703-3205
(757) 483-6404
(757) 483-0737
Mailing address
3300 ACADEMY AVENUE, PORTSMOUTH, VA 23703-3205
(757) 483-6404
(757) 483-0737
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002140
VA
106H00000X
Marriage & Family Therapist
0717000203
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005409357
—
VA
01
—
214324
ANTHEM BCBS
VA
01
—
O81365
SENTARA/OPTIMA HEALTH INS
VA
Enumeration date
05/17/2006
Last updated
10/19/2012
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