Provider Demographics
NPI:1194879742
Name:LADD, TERRILYN HOLLINGS (ED, S, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TERRILYN
Middle Name:HOLLINGS
Last Name:LADD
Suffix:
Gender:F
Credentials:ED, S, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3074 HICKORY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1265
Mailing Address - Country:US
Mailing Address - Phone:423-209-7751
Mailing Address - Fax:
Practice Address - Street 1:3074 HICKORY VALLEY RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1265
Practice Address - Country:US
Practice Address - Phone:423-209-7751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP 4515235Z00000X
TN4059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA323623953BMedicaid
TN1519783Medicaid