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Individual
LISA LADEW
Active
Individual
LISA LADEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00608
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058
NHPRC
RI
01
—
4600103
UNITED
RI
05
—
9009994
—
RI
01
—
99947
BLUE CROSS
RI
Enumeration date
05/09/2007
Last updated
07/09/2007
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