Provider Demographics
NPI:1588908396
Name:RABBANI, LADAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LADAN
Middle Name:
Last Name:RABBANI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 MALCOLM AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4790
Mailing Address - Country:US
Mailing Address - Phone:310-927-6321
Mailing Address - Fax:
Practice Address - Street 1:1817 MALCOLM AVE APT 301
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4790
Practice Address - Country:US
Practice Address - Phone:310-927-6321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20862235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPEOtherSPEECH THERAPY