Provider Demographics
NPI:1003123340
Name:MCMAHON, ABIGAIL M (AUD)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:M
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:MCMAHON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:2045 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5437
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:2045 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5437
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO608231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO021412OtherKAISER COMMERCIAL NUMBER
CO02822776Medicaid
CO021412OtherKAISER COMMERCIAL NUMBER