Provider Demographics
NPI:1518099811
Name:LADAMUS, ANNAMARIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANNAMARIA
Middle Name:
Last Name:LADAMUS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W 200 N
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:UT
Mailing Address - Zip Code:84631-4565
Mailing Address - Country:US
Mailing Address - Phone:435-743-6334
Mailing Address - Fax:
Practice Address - Street 1:681 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-1824
Practice Address - Country:US
Practice Address - Phone:435-896-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT52255176004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional