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General NPI Number Information
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NPI Number | 1427894179
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Entity Type | Individual
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Provider Name | MCKENNA MARIE LUDWIG MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 2911 LONGVIEW DR
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City | JONESBORO
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State | AR
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Zip | 72401-5911
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Country | US
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Telephone | 870-336-0238
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Fax |
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Provider Business Mailing Address
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Address Line | 223 RICHMOND AVE
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City | TAYLORVILLE
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State | IL
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Zip | 62568-9073
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 203388
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License Number State | AR
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