MEDICARE: LAUREN SLEDGE BLACKMON SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7892	LA

General Provider Information

NPI Number	:	1306360870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SLEDGE BLACKMON SLP

Provider Business Mailing Address
First Line	:	107 SUMMER LN
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-3501
Country	:	US
Telephone Number	:	318-396-1969
Fax Number	:	318-396-1970

Provider Business Practice Location Address
First Line	:	107 SUMMER LANE
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-3051
Country	:	US
Telephone Number	:	318-396-1969
Fax Number	:	318-396-1970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	04/20/2026

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Directions to “ LAUREN SLEDGE BLACKMON SLP” Practice Location

Language	Start Address	Practice Location

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