Provider Demographics
NPI:1407185937
Name:LADD, DONNA M (OTR)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:LADD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1896 PARK MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3738
Mailing Address - Country:US
Mailing Address - Phone:239-939-3725
Mailing Address - Fax:
Practice Address - Street 1:1896 PARK MEADOWS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3738
Practice Address - Country:US
Practice Address - Phone:239-939-3725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12327225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist