MEDICARE: SHARON WHEELOCK LUDLOW

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	SLP005666	GA

General Provider Information

NPI Number	:	1841437829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON WHEELOCK LUDLOW

Provider Business Mailing Address
First Line	:	2395 WALL ST SE
Second Line	:	SUITE 170
City	:	CONYERS
State	:	GA
Zip	:	30013-6703
Country	:	US
Telephone Number	:	678-462-3637
Fax Number	:

Provider Business Practice Location Address
First Line	:	2395 WALL ST SE
Second Line	:	SUITE 170
City	:	CONYERS
State	:	GA
Zip	:	30013-6703
Country	:	US
Telephone Number	:	678-462-3637
Fax Number	:

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

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	03/08/2016

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Directions to “ SHARON WHEELOCK LUDLOW ” Practice Location

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