Individual
MISS WANDA RENEE' LADSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 MULBERRY ST, SPRINGFIELD, MA 01105-1433
(860) 655-8197
Mailing address
2006 CANYON RIDGE DR, BROAD BROOK, CT 06016-5617
(860) 655-8197
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/07/2013
Last updated
09/07/2013
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