MEDICARE: LAURA LADEWSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	TSLP5246	AZ

General Provider Information

NPI Number	:	1831232214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA LADEWSKI

Provider Business Mailing Address
First Line	:	3255 S DORSEY LN APT 1061
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-3967
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6602 W OSBORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-4533
Country	:	US
Telephone Number	:	623-691-4600
Fax Number	:	623-691-4620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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Directions to “ LAURA LADEWSKI ” Practice Location

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