Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 264 | MT |
Y | 103TC0700X | Clinical Psychologist | 264 | MT |
NPI | 1003013574 |
---|---|
Provider Name | Dr. Karen Ruth Ladanye |
First Address | Missoula, MT 59802-4407 |
Second Address | Missoula, MT 59802-4407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 12/01/2012 |