Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 0701004150 | VA |
NPI | 1003010760 |
---|---|
Provider Name | Ms. Saundra Kay Ladd |
First Address | Fairfax, VA 22031-3415 |
Second Address | Fairfax, VA 22031-3415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 19/02/2009 |