Leisa Dianne Ludlam, PH.D

NPI #1497781835 in Pace, Florida

Provider Information

NPI Number: 1497781835
Entity Type: Individual
Name: Leisa Dianne Ludlam, PH.D
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Clinical
Credential: PH.D
Enumeration Date: Jun 25, 2006
Last Updated: Jun 5, 2008

Practice Location

Address: 4509 WOODBINE RD
City: Pace
State: Florida
ZIP Code: 32571-8706
Phone: (850) 995-2500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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