Provider Demographics
NPI:1477280121
Name:LADSON, ALISON R
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:R
Last Name:LADSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:R
Other - Last Name:PIZAREK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:51565 FORESTBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-1852
Mailing Address - Country:US
Mailing Address - Phone:574-309-7432
Mailing Address - Fax:
Practice Address - Street 1:4010 S IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-2200
Practice Address - Country:US
Practice Address - Phone:574-216-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant