Doctor Name: | MRS. COLLENE ALYCE LADD |
NPI Number: | 1972713659 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 3294 |
Business Practice Address: | 2400 Unser Blvd Se Rio Rancho, NM - 871243392 |
Business Phone Number: | 5052537223 |
Business Fax Number: | 5052531517 |
Mailing Address: | 2400 Unser Blvd Se, RIO RANCHO |
State: | NM |
Postal Code: | 871243392 |
Phone Number: | 5052537223 |
Fax Number: | 5052531517 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 01/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |