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General NPI Number Information
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NPI Number | 1316080112
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Entity Type | Individual
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Provider Name | ANN LADD PHD, LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 279 S JOE MARTINEZ BLVD
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City | PUEBLO WEST
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State | CO
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Zip | 81007-5439
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Country | US
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Telephone | 719-251-4006
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Fax |
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Provider Business Mailing Address
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Address Line | 257 S MANGRUM PL PO BOX 7164
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City | PUEBLO WEST
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State | CO
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Zip | 81007-3636
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Country | US
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Telephone | 719-647-1746
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 992927
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3270
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License Number State | OR
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