Provider Demographics
NPI:1134286305
Name:LADD, ANNETTE J (MA)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:J
Last Name:LADD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 E INA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7016
Mailing Address - Country:US
Mailing Address - Phone:520-791-9974
Mailing Address - Fax:520-791-0676
Practice Address - Street 1:480 E INA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7016
Practice Address - Country:US
Practice Address - Phone:520-791-9974
Practice Address - Fax:520-791-0676
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional