Provider Demographics
NPI:1306026232
Name:LADIN, BARBARA OLTZIK
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:OLTZIK
Last Name:LADIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11313 KNOT WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1361
Mailing Address - Country:US
Mailing Address - Phone:954-295-1383
Mailing Address - Fax:
Practice Address - Street 1:2771 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 7
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3642
Practice Address - Country:US
Practice Address - Phone:954-389-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6677235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist