Provider Demographics
NPI:1003480682
Name:SIMONSON, ABIGAIL J (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:J
Last Name:SIMONSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:J
Other - Last Name:CARRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2725 S MOORLAND RD.
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151
Mailing Address - Country:US
Mailing Address - Phone:414-329-2428
Mailing Address - Fax:
Practice Address - Street 1:2725 S MOORLAND RD.
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151
Practice Address - Country:US
Practice Address - Phone:414-329-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6981-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist