MEDICARE: LAUREN WARD

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	SLP009057	GA

General Provider Information

NPI Number	:	1437522083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN WARD

Provider Business Mailing Address
First Line	:	3640 S FULTON AVE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30354-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1514 CLEVELAND AVE
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-6965
Country	:	US
Telephone Number	:	678-608-9607
Fax Number	:

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

Provider Enumeration Date	:	11/04/2015
Last Update Date	:	11/04/2015

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Directions to “ LAUREN WARD ” Practice Location

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