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General NPI Number Information
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NPI Number | 1346461167
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Entity Type | Individual
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Provider Name | BRIGITTE LADISCH PHD
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2000 P ST NW SUITE 710
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City | WASHINGTON
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State | DC
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Zip | 20036-5915
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Country | US
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Telephone | 301-654-2124
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Fax | 301-652-6250
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Provider Business Mailing Address
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Address Line | 3222 PICKWICK LN
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City | CHEVY CHASE
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State | MD
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Zip | 20815-4042
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Country | US
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Telephone | 301-654-2124
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Fax | 301-652-6250
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY1899
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 02903
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License Number State | MD
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