Provider Demographics
NPI:1427839059
Name:LADENDORF, JENNIFER L (MS SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:LADENDORF
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 1ST ST E
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5211
Mailing Address - Country:US
Mailing Address - Phone:701-713-0794
Mailing Address - Fax:701-483-0060
Practice Address - Street 1:2201 36TH AVE SW STE B
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-7593
Practice Address - Country:US
Practice Address - Phone:701-837-9801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist