| Leisa D. Ludlam, Ph.d.,p.a. | |
|
4509 Woodbine Rd Pace FL 32571-8706 | |
| (850) 995-2500 | |
| (850) 995-2501 |
| Full Name | Leisa D. Ludlam, Ph.d.,p.a. |
|---|---|
| Speciality | Psychologist |
| Location | 4509 Woodbine Rd, Pace, Florida |
| Authorized Official Name and Position | Leisa D Ludlam (OWNER) |
| Authorized Official Contact | 8509952500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leisa D. Ludlam, Ph.d.,p.a. 4509 Woodbine Rd Pace FL 32571-8706 Ph: (850) 995-2500 | Leisa D. Ludlam, Ph.d.,p.a. 4509 Woodbine Rd Pace FL 32571-8706 Ph: (850) 995-2500 |
| NPI Number | 1295271443 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 01/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295271443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY4705 (Florida) | Primary |
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