Provider Demographics
NPI:1780381079
Name:YURCO, ANN MARGARET LUDLOW (OT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARGARET LUDLOW
Last Name:YURCO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARGARET
Other - Last Name:LUDLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:151B RUTLEDGE AVE # MSC962
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-9620
Mailing Address - Country:US
Mailing Address - Phone:843-792-0701
Mailing Address - Fax:
Practice Address - Street 1:501 FOREST LN
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2621
Practice Address - Country:US
Practice Address - Phone:864-654-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC6855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program