| Doctor Name: | DR. PETER DORIAN LADD |
| NPI Number: | 1033449798 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 0003576-1 |
| Business Practice Address: | 38047 Windward Cliffs Lane Clayton, NY - 136240184 |
| Business Phone Number: | 3152283671 |
| Business Fax Number: | 3156860026 |
| Mailing Address: | Po Box 184, CLAYTON |
| State: | NY |
| Postal Code: | 136240184 |
| Phone Number: | 3152283671 |
| Fax Number: | 3156860026 |
| NPI Enumeration Date: | 12/31/2009 |
| NPI Last Update Date: | 12/31/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 0003576-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |