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Individual

BRUCE L LADLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
30 E APPLE ST, SUITE 6255, DAYTON, OH 45409-2939
(937) 208-4452
(937) 208-3893
Mailing address
30 E APPLE ST, SUITE 6255, DAYTON, OH 45409-2939
(937) 208-4452
(937) 208-3893

Taxonomy

Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
4850
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0981497
OH
01
31053750400
BWC PSYCHOLOGIST
ND
05
5935608
OH
Enumeration date
10/04/2006
Last updated
08/13/2014
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