Individual
JACQUELYN LUDLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5001 STATESMAN DR, IRVING, TX 75063-2414
(469) 524-1506
(972) 983-0267
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 444-6350
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
114218
TX
225X00000X
Occupational Therapist
277474
OR
225X00000X
Occupational Therapist
Primary
46TR00537800
NJ
Other
Enumeration date
06/05/2011
Last updated
01/03/2014
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