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General NPI Number Information
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NPI Number | 1083883482
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Entity Type | Individual
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Provider Name | LAWRENCE J LADDEN PHD
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Gender | Male
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 1831 CHESTNUT ST 801
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City | PHILADELPHIA
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State | PA
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Zip | 19103-3713
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Country | US
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Telephone | 215-561-0341
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Fax |
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Provider Business Mailing Address
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Address Line | 8244 BROOKSIDE RD
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City | ELKINS PARK
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State | PA
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Zip | 19027-2404
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Country | US
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Telephone | 215-561-0341
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS005654L
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License Number State | PA
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