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Individual

CHRISTINA MARIE LADD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Mailing address
9870 NW UNION RD, MOORESVILLE, IN 46158-6123
(317) 550-7553
(228) 865-1700

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1906
MS
101YP2500X
Professional Counselor
Primary
39002270A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00018213
MS
Enumeration date
08/13/2008
Last updated
10/15/2015
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