Provider Demographics
NPI:1104226232
Name:LADNIER, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:LADNIER
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 1:500 FAIRWAY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10211 SIEGEN LN STE 2A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-4988
Practice Address - Country:US
Practice Address - Phone:225-769-2533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2023-04-20
Deactivation Date:2023-03-17
Deactivation Code:
Reactivation Date:2023-04-17
Provider Licenses
StateLicense IDTaxonomies
LA7860101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health