Provider Demographics
NPI:1407305667
Name:LADOW, JESSICA R (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:LADOW
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9180 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-3126
Mailing Address - Country:US
Mailing Address - Phone:614-282-1499
Mailing Address - Fax:435-251-2255
Practice Address - Street 1:9180 FOREST LN
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-3126
Practice Address - Country:US
Practice Address - Phone:614-282-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11656235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist