Provider Demographics
NPI:1508856709
Name:LADD, SANDRA A (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:LADD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-2964
Mailing Address - Country:US
Mailing Address - Phone:802-254-4699
Mailing Address - Fax:802-257-1985
Practice Address - Street 1:56 LINDEN ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-2964
Practice Address - Country:US
Practice Address - Phone:802-254-4699
Practice Address - Fax:802-257-1985
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0000949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00005022OtherPRIVATE INSURANCE (BCBS)
VT1006687Medicaid
NH30391424Medicaid
NH0801982Y0VT01OtherPRIVATE INSURANCE (BCBS)
956980OtherPRIVATE INSURANCE (MVP)
VT1006687Medicaid