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General NPI Number Information
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NPI Number | 1497801591
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Entity Type | Individual
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Provider Name | ELIZABETH K LADD ED. D, PHD
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 12/30/2023
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Provider Practice Location Address
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Address Line | 5789 BATTLEFIELD PKWY
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City | RINGGOLD
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State | GA
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Zip | 30736-5154
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Country | US
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Telephone | 423-451-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 5789 BATTLEFIELD PKWY
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City | RINGGOLD
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State | GA
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Zip | 30736-5154
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Country | US
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Telephone | 423-451-2111
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY002841
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License Number State | GA
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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 | PSY002841
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY002841
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 82-07P
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License Number State | AR
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