Provider Demographics
NPI:1770173627
Name:LADAGA, FRANCES LICIA MINANO (MS)
Entity type:Individual
Prefix:
First Name:FRANCES LICIA
Middle Name:MINANO
Last Name:LADAGA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 EVENING STAR PL
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721
Mailing Address - Country:US
Mailing Address - Phone:301-633-5604
Mailing Address - Fax:
Practice Address - Street 1:4485 FORBES BLVD.
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-429-2900
Practice Address - Fax:443-458-7242
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2024-04-16
Deactivation Date:2022-02-18
Deactivation Code:
Reactivation Date:2024-04-15
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD02486235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program