Provider Demographics
NPI:1659866317
Name:LADUKE, SARAH MAE (MED CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MAE
Last Name:LADUKE
Suffix:
Gender:F
Credentials:MED CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15265 MINNETONKA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-1510
Mailing Address - Country:US
Mailing Address - Phone:952-223-2506
Mailing Address - Fax:952-443-2038
Practice Address - Street 1:9346 OAK AVE
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387
Practice Address - Country:US
Practice Address - Phone:952-223-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10093235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist