Provider Demographics
NPI:1205264298
Name:LADAVAT, ALLISON ANN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ANN
Last Name:LADAVAT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800B MCKNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6020
Mailing Address - Country:US
Mailing Address - Phone:412-364-2446
Mailing Address - Fax:
Practice Address - Street 1:9800B MCKNIGHT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6020
Practice Address - Country:US
Practice Address - Phone:412-364-2446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011693235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist