Individual
MRS. ANNA MATSUDA LADISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
3295 MENDEL DR, WEST LAFAYETTE, IN 47906-5177
(561) 252-9909
(480) 287-8021
Mailing address
3295 MENDEL DR, WEST LAFAYETTE, IN 47906-5177
(561) 252-9909
(480) 287-8021
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004643A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12907686
ASHA CERTIFICATION
MD
01
—
22004643A
INDIANA STATE BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
IN
Enumeration date
02/27/2009
Last updated
02/27/2009
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