LADONNA WALLACE (NPI# 1962750679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962750679 |
| Entity Type | Individual |
| Full Name | LADONNA WALLACE |
| Practice Address |
106 1/2 Se 2nd Street Antlers OK 74523-0000 |
| Practice Telephone | 5802981199 |
| Practice Fax Number | 5802981199 |
| Mailing Telephone | 5802981199 |
| Mailing Fax Number | 5802981199 |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528328200 | Ladonna Wallace | Home Health Aide | 1728 W St Se Apt F105, Washington, DC 20020-4234 | 2012-05-29 |
| Street Address |
106 1/2 SE 2ND STREET |
| City | ANTLERS |
| State | OK |
| Zip Code | 74523-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942793351 | Terry Jean Draper | Nurse Practitioner | 416020 E 1951 Rd, Antlers, OK 74523 | 2018-06-11 |
| 1134628456 | Breiana Jacobs | Case Manager/Care Coordinator | 107 South High St, Antlers, OK 74523 | 2018-02-02 |
| 1174072482 | Crossroads 1010 LLC | Community/Behavioral Health | 193908 Us Hwy 271, Antlers, OK 74523 | 2016-09-27 |
| 1700277092 | Katherine Jill Maple | Registered Nurse | 506 Hwy 271 North, Antlers, OK 74523 | 2015-02-09 |
| 1366884975 | Jessica L. Rowan | Speech-Language Pathologist | 426297 State Highway 3, Antlers, OK 74523 | 2013-07-24 |
| 1235432444 | Charis Kay Griffin | Psychologist | 903 West Main St., Antlers, OK 74523 | 2010-12-09 |
| 1629213889 | Hometown Quality Care, Inc | Home Health | 191475 N 4140 Rd Ste 3, Antlers, OK 74523 | 2008-12-02 |
| 1841491214 | Zen Gee Counseling & Psychological Serv LLC | Community/Behavioral Health | 608 Highway 271 North, Antlers, OK 74523 | 2007-05-31 |
| 1376689422 | Marcia Leigh Armstrong | Counselor | 608 Hwy 271 North, Antlers, OK 74523 | 2007-01-29 |
| 1831247691 | Chance J Lawless | Dentist | 412 N Hwy 271, Antlers, OK 74523 | 2007-01-08 |
| Find all providers in zip 74523 | ||||
| Taxonomy Code | 103TR0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831449727 | Pattie Parks | Psychologist | 106 1/2 Se 2nd, Antlers, OK 74523-0000 | 2012-09-18 |
| 1942558796 | Jane Marva Breckenridge | Psychologist | 112 N High St, Antlers, OK 74523-2250 | 2012-08-28 |
| 1780932509 | Terinia Noel | Psychologist | 1061/2 South East 2nd Street, Antlers, OK 74523-0000 | 2012-08-28 |
| 1124374194 | Geni A Hutchings | Psychologist | 106 1/2 S.e. 2nd, Antlers, OK 74523-0000 | 2012-07-27 |
| 1235432444 | Charis Kay Griffin | Psychologist | 903 West Main St., Antlers, OK 74523 | 2010-12-09 |
| 1164851614 | Sidney Deupree | Psychologist | 217 N High St, Antlers, OK 74523-2237 | 2013-11-05 |
| 1982046744 | Rebecca Barnes | Psychologist | 106 1/2 Se 2nd, Antlers, OK 74523 | 2013-07-22 |
| 1144562265 | Kristi J Graham | Psychologist | 112 N High St, Antlers, OK 74523-2250 | 2013-03-27 |
| 1225373194 | Jenice Jones | Psychologist | 112 N High St, Antlers, OK 74523-2250 | 2012-12-04 |
| 1942545009 | Bernita Ellen Taylor | Psychologist | 112 N High St, Antlers, OK 74523-2250 | 2012-11-30 |
| Find all providers in ANTLERS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.