Individual
FREDERICK W LADD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1075 BURNS ST, DETROIT, MI 48214-4300
(313) 922-2222
Mailing address
1075 BURNS ST, DETROIT, MI 48214-4300
(313) 922-2222
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6803004563
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6803004563
SOCIAL WORK TECH
MI
Enumeration date
03/15/2007
Last updated
07/08/2007
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