Provider Demographics
NPI:1366055139
Name:LADYMAN, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LADYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 W WILDFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-8777
Mailing Address - Country:US
Mailing Address - Phone:317-650-4622
Mailing Address - Fax:
Practice Address - Street 1:302 N JOHNSON RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-5504
Practice Address - Country:US
Practice Address - Phone:317-834-7425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006695A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist