Healthcare Provider Details

I. General information

NPI: 1174933154
Provider Name (Legal Business Name): AMY LADEW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2014
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4655 ROSEBUD LN
NEWBURGH IN
47630-9366
US

IV. Provider business mailing address

1327 E ILLINOIS ST
EVANSVILLE IN
47711-5746
US

V. Phone/Fax

Practice location:
  • Phone: 812-213-9366
  • Fax: 317-520-8200
Mailing address:
  • Phone: 618-780-1815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: