Provider Demographics
NPI:1063008910
Name:CONRAD, ABBY ELIZABETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:ELIZABETH
Last Name:CONRAD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 WHITEPINE CT
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8141
Mailing Address - Country:US
Mailing Address - Phone:515-422-6439
Mailing Address - Fax:
Practice Address - Street 1:3060 WHITEPINE CT
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8141
Practice Address - Country:US
Practice Address - Phone:515-422-6439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist